Štefan Hrušovský
Chronic hepatitis C and chronic hepatitis B are fibrogenic and cirrhogenic. With alcoholic liver disease, they are the most common precanceroses for hepatocellular carcinoma. Effective screening, diagnosis and treatment of chronic hepatitis C and B diminish the risk of hepatocellular carcinoma. This tumour occurs usually at the stage of liver cirrhosis. The incidence is highest in 7th and 9th decade of life. In the patient with chronic hepatitis C or B, the manifestation of hepatocellular carcinoma may be the onset of icterus, portal vein or another vein thrombosis, Budd-Chiari syndrome, ascites, malnutrition, progression of weakness and hepatic failure. All these are late manifestations, tumour has to be screened actively in patients with hepatitis C or B, examining blood alfa-fetoprotein and abdominal ultrasound every 6 months, at stage of liver cirrhosis every 3-4 months. The diagnosis is established by means of contrast ultrasonography, sequentional contrast CT, MRI with gadoxetin, in unclear situations by means of US, CT or surgically-guided biopsy. The curative treatment is represented by radical resection, liver transplantation, radiofrequency ablation; palliative treatment by trans-arterial chemoembolization and treatment by sorafenib. The ongoing clinical studies will evaluate the combination treatments.