Moving toward an understanding of the metastatic process in hepatocellular carcinoma

INTRODUCTIONClinical factors contributing to the therapeutic challenge ofhepatocellular carcinoma(HCC)are manifold:tumors arise often inpatients with compromised liver function,therefore limitingtherapeutic options;symptoms develop only at later stages of tumorprogression,and tumors tend to invade normal structures or occur inmultiple locations simultaneously.Ninety percent of patients withtumors larger than 5 cm will have synchronous intrahepatic metastasesat the time of presentation.In the majority of patients undergoingpartial hepatectomy for HCC,intra-hepatic or distant metastases willoccur.Likewise,in about fifty percent of the patients who die