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Skip to Main Content Close theclinics.com Home Articles & Issues Back Articles in Press Buy Back Issues Current Issue Future Issues Past Issues Series Information Back About Abstracting/Indexing Consulting Editor Contact Information Media Information Subscribe Go search All Content Article Title, Abstract, Keywords Authors Article Title Abstract Advanced Search Log in Register Log in Subscribe Claim On the Cover Subscribe to Journal August 2020 Volume 24, Issue 3 Consulting Editor: Norman M. Gitlin, MD, FRCP [LONDON], FRCPE New Content Alerts Publishing Information Clinics in Liver Disease is published by Elsevier . Current Issue August 2020 Volume 24, Issue 3 Current Topic August 2020 Consultations in Liver Disease Edited by Steven L. Flamm Community practitioners in the field of Gastroenterology are frequently consulted to evaluate inpatients and outpatients with acute and chronic liver issues. Many of the medical problems are complex, and recent advances in the field may be difficult to follow for busy providers. This issue of Clinics in Liver Disease on Consultations in Liver Disease is the fourth in a series dedicated to supporting community providers with pertinent clinical information about consultations that are commonly encountered in community practice. Recent Issues Articles in Press Past Issues Most Read 2020 - Volume 24 May 2020 Hepatic Encephalopathy Edited by Vinod K. Rustgi February 2020 Drug Hepatotoxicity Edited by Pierre M. Gholam Tyrosine Kinase Inhibitors and Hepatocellular Carcinoma Leonardo G. da Fonseca, Maria Reig, Jordi Bruix DOI: https://doi.org/10.1016/j.cld.2020.07.012 Publication stage: In Press Corrected Proof Preview Full-Text HTML PDF x Sorafenib was the first tyrosine kinase inhibitor (TKI) that showed success in extending survival in patients with advanced hepatocellular carcinoma (HCC). In recent years, additional TKIs have been shown to improve survival and expanded the armamentarium for treating this malignancy. The current landscape includes other classes of drugs, such as immune checkpoint inhibitors and monoclonal antibodies. The challenge is now placed on how to best select, combine, and sequence drugs with the goal of improving efficacy and minimizing toxicities to deliver better outcomes for HCC patients. Multidisciplinary Team Management of Hepatocellular Carcinoma Is Standard of Care Dekey Lhewa, Ellen W. Green, Willscott E. Naugler DOI: https://doi.org/10.1016/j.cld.2020.07.009 Publication stage: In Press Corrected Proof Preview Full-Text HTML PDF x Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, but unlike other leading causes of cancer death, HCC is increasing in mortality and burden of management. Management of HCC is unique because it usually arises in a diseased liver, which itself may be a driver of mortality. Multidisciplinary teams (MDTs) for the management of complex diseases are becoming more common, but are especially needed in the management of patients with HCC. Liver cancer MDTs are used in most centers providing comprehensive care for patients with HCC, and should be considered the standard of care for these patients. Surveillance for Hepatocellular Carcinoma Jorge A. Marrero DOI: https://doi.org/10.1016/j.cld.2020.07.013 Publication stage: In Press Corrected Proof Preview Full-Text HTML PDF x Patients with cirrhosis of the liver have a very high risk for developing hepatocellular carcinoma (HCC). Therefore, this group of patients should undergo surveillance to improve mortality. Better tools for stratifying the risk of HCC among patients with cirrhosis are needed. The best strategy for surveillance is the combination of alpha-fetoprotein and ultrasound of the liver every 6 months. This strategy shows a sensitivity of approximately 65% and a specificity of 90%, and importantly, has been shown to improve mortality in these patients. Balancing benefits and harms should be performed when deciding to proceed with surveillance. Hepatocellular Carcinoma: Role of Pathology in the Era of Precision Medicine Monika Vyas, Xuchen Zhang DOI: https://doi.org/10.1016/j.cld.2020.07.010 Publication stage: In Press Corrected Proof Preview Full-Text HTML PDF x Hepatocellular carcinoma (HCC) is a morphologically heterogeneous tumor with variable architectural growth patterns and several distinct histologic subtypes. Large-scale attempts have been made over the past decade to identify targetable genomic alterations in HCC; however, its translation into clinical personalized care remains a challenge to precision oncology. The role of pathology is no longer limited to confirmation of diagnosis when radiologic features are atypical. Pathology is now in a position to predict the underlying molecular alteration, prognosis, and behavior of HCC. This review outlines various aspects of histopathologic diagnosis and role of pathology in cutting-edge diagnostics of HCC. Downstaging to Liver Transplant: Success Involves Choosing the Right Patient Kali Zhou, Neil Mehta DOI: https://doi.org/10.1016/j.cld.2020.07.005 Publication stage: In Press Corrected Proof Preview Full-Text HTML PDF x Hepatocellular carcinoma is a rising indication for liver transplantation in the United States. Downstaging, defined as the reduction of tumor burden using local-regional therapy into Milan criteria, opens an avenue to access cure through transplant for patients who traditionally would not qualify. Approaching the selection of downstaging candidates through an assessment of hepatic function, staying within a modest expansion of tumor burden, and incorporation of serologic/imaging markers for tumor biology provide the best chance for successful downstaging. Following well-defined downstaging protocols with built-in failure criteria ensures excellent post-transplant outcomes. View More Articles in Press 2019 - Volume 23 November 2019 Portal Hypertension Sammy Saab, MD, MPH, AGAF, FAASLD, FACG, Editor August 2019 Hepatitis B Virus Update Tarek I. Hassanein, MD, FACP, FACG, AGAF, FAASLD, Editor May 2019 Liver in Systemic Diseases Jorge L. Herrera, MD, Editor February 2019 Alcoholic Liver Disease Norman L. Sussman, MD, FAASLD, Michael R. Lucey, MD, FAASLD, Editors 2018 - Volume 22 November 2018 Pediatric Liver Disease Philip Rosenthal, MD, Editor August 2018 Primary Biliary Cholangitis Elizabeth J. Carey, MD, Cynthia Levy, MD, Editors May 2018 Acute Liver Failure Nikolaos T. Pyrsopoulos, MD, PhD, MBA, FACP, AGAF, FAASLD, FRCP (Edin), Editor February 2018 NASH and NAFLD David E. Bernstein, MD, Editor 2017 - Volume 21 November 2017 Consultations in Liver Disease Steven L. Flamm, MD, Editor August 2017 Hepatitis C Infection as a Systemic Disease: Extra-Hepatic Manifestation of Hepatitis C Zobair M. Younossi, MD, MPH, FACG, AGAF, FAASLD, Editor May 2017 Liver Transplantation Roberto J. Firpi, MD, MS, AGAF, FAASLD, FACG, Editor February 2017 Drug Hepatotoxicity Vinod K. Rustgi, MD, MBA, Editor 2016 - Volume 20 November 2016 Hepatitis B Virus Tarek I. Hassanein, MD, FACP, FACG, AGAF, FAASLD, Editor August 2016 Alcoholic Liver Disease Stanley Martin Cohen, MD, FAASLD, FACG, Editor May 2016 Non-Alcoholic Fatty Liver Disease Paul J. Gaglio, MD, FACP, AGAF, FAASLD, Editor February 2016 Advances in Cholestatic Liver Diseases Cynthia Levy, MD, Editor 2015 - Volume 19 November 2015 Current Management of Hepatitis C Virus Fred Poordad, MD, Editor August 2015 New Advances in Hepatic Encephalopathy Robert S. Brown Jr, MD, MPH, Editor May 2015 Hepatocellular Carcinoma in Adults and Children Adrian Reuben, BSc, MBBS, FRCP, FACG, FAASLD, Editor February 2015 Consultations in Liver Disease Steven L. Flamm, MD, Editor 2014 - Volume 18 November 2014 Interventional Procedures in Hepatobiliary Diseases Andres Cardenas, Paul J. Thuluvath, Editors August 2014 Liver Transplantation: Update of Concepts and Practice Kalyan Ram Bhamidimarri, Editor May 2014 Portal Hypertension Jorge L. Herrera, Editor February 2014 The Impact of Obesity and Nutr...