“
“Upper gastrointestinal endoscopy is a procedure that allows for visualization

of the esophagus, stomach and proximal small bowel. There are a variety AZD5363 clinical trial of technical and cognitive aspects that must be mastered in order to perform a high quality examination. The aim of this chapter is to describe the elements of a complete and thorough upper endoscopy, and to review the key elements of that procedure, including tissue sampling. “
“I read with interest the updated practice guidelines for the management of hepatocellular carcinoma (HCC) by the American Association for the Study of Liver Diseases.1 It is undeniable that the Barcelona Clinic Liver Cancer staging system has become widely accepted in clinical practice. However, the management options for each stage appear to be too rigidly restricted. For example, percutaneous ethanol injection (PEI) can be considered for patients with liver nodules that are inaccessible to radiofrequency ablation, but in comparison with either treatment as monotherapy, the combination of radiofrequency ablation and PEI has been shown to be more effective for long-term survival.2 For intermediate-stage patients, transarterial chemoembolization (TACE) seems to be

the treatment of choice. However, in comparison with TACE alone, the combination of TACE and Selleckchem ABT-888 PEI has been demonstrated to prolong survival in patients with small lesions and in patients with advanced lesions.3, 4 On the other hand, although the use of sorafenib in patients with advanced HCC has been proven to prolong survival, the reported partial response rate is only 2%, and no patients have achieved a complete response.5 Our group has demonstrated that an intra-arterial infusion of chemotherapy can lead to a complete response in 9.4% of patients with advanced HCC and to a partial response in 18.9%.6 Thus, for patients with advanced HCC, an intra-arterial

infusion of chemotherapy is a viable alternative to sorafenib. Gin-Ho Lo M.D.*, * Digestive Center, Department of Medical Education, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. “
“BACKGROUND: Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Over 600,000 new cases are diagnosed each year. Early stage disease can be cured with surgical resection or liver transplantation. Liver MCE transplantation offers the best chance at a cure; however, recurrence rates are as high as 40% for those transplanted. The enumeration of circulating tumor cells (CTCs) is an independent prognostic biomarker in patients with malignancies including breast and colon cancer. CTCs in the peripheral blood of HCC patients have been correlated to tumor size, portal vein tumor thrombosis, and stage. There is no data regarding the utility of CTC identification and molecular characterization to predict patients at high risk of HCC recurrence.