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Topic: Natural Products and Hepatocellular Carcinoma

Natural products and hepatocellular carcinoma: a review
Natural products and hepatocellular carcinoma: a review

Asma M. Alnajjar , Hussien A. Elsiesy 1,2
1
1 College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
2 Department of Liver and Small Bowel Transplantation and Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital and
Research Center, Riyadh 11211, Saudi Arabia

ABSTRACT
Hepatocellular carcinoma (HCC) is the fi fth commonest cause of malignancy and the third cause of cancer mortality.
There are different treatment options for HCC ranging from loco-regional therapy to surgical treatment. Different regimen
of systemic chemotherapy has been tried with a poor response. Several studies aimed at discovering more molecules for
the management of HCC. Those studies aimed at recognizing and targeting several signaling and molecular pathways that
lead to cellular proliferation and tumor formation. In this review, we discussed the role of several agents found in natural and
dietary products such as curcumin, resveratrol, fl avonoids, Rubus aleaefolius Poir total alkaloids, Livistona chinensis seed,
and crocetin. We had used the names of the above-mentioned products as key words in addition to “HCC” on PubMed to
fi nd studies that discussed their roles in HCC. Articles were downloaded for reviewing and discussing natural products that
had adequate studies in treating HCC.

Key words: Hepatocellular carcinoma; molecular signaling; natural products

Address for correspondence:
Dr. Hussien A. Elsiesy, Department of Liver and Small Bowel Transplantation and Hepatobiliary and Pancreatic Surgery, King Faisal Specialist
Hospital and Research Center, MBC 72, P. O. Box: 3354, Riyadh 11211, Saudi Arabia. E-mail: helsiesy@gmail.com
Received: 04-09-2015, Accepted: 23-09-2015

INTRODUCTION Hepatic carcinogens, viral hepatitis, and liver cirrhosis
[12]
induce inflammation and oxidative stress. Production of
Hepatocellular carcinoma (HCC) is the fifth commonest free radicals (such as oxygen and nitrogen species) as well as
cause of malignancy and the third cause of cancer cytokines and chemokines lead to cellular injury. Following
[12]
mortality. [1,2] Most patients with HCC were diagnosed in that, cellular proliferation happens, leading to malignant
advanced stage that carried poor outcome with an overall transformation. [13,14] Moreover, signaling processes at the
5-year survival rate of < 9%. [3,4] An estimation of 21,000 cellular and molecular levels are involved throughout the
deaths related to HCC was reported in the US in 2012. development of HCC. [15-17]
[5]
HCC has been frequently reported in Sub-Saharan Africa,
Europe, North America, and Asia. [6,7] Most HCC occurs in Management of HCC is rather complex compared to other
the patients with liver cirrhosis mainly related to hepatitis malignancy; it happens mostly in the setting of liver
B and C infections, hemochromatosis, non-alcoholic cirrhosis, and the treatment option largely depends on
steatohepatitis, alcohol consumption, nitrosamines, and the stage of liver disease, the patient’s functional status,
aflatoxins. [8-11] number, size and location of tumor, and the presence or

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DOI:
10.4103/2394-5079.167379 How to cite this article: Alnajjar AM, Elsiesy HA. Natural products and
hepatocellular carcinoma: a review. Hepatoma Res 2015;1:119-24.

© 2015 Hepatoma Research | Published by Wolters Kluwer - Medknow 119