Hepatocellular carcinoma: Present status and prospects

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection. Hepatocellular carcinoma (HCC) represents more than 5% of all cancers in the world, and the estimated number of cancer-related deaths exceeds 500,000 per year. If caught early, it can sometimes be cured with surgery or transplant. In more advanced cases it can’t be cured, but treatment and support can help live longer and better.

Unfortunately, HCC is typically diagnosed late in its course, with a median survival following diagnosis of approximately 6 to 20 months. In the United States, 2 years survival is less than 50% and 5-year survival is only 10%.

Current international vaccination strategies for hepatitis B virus (HBV), and advances in the management of hepatitis C virus (HCV) infections, promise to have a major impact on the incidence of HCC. Meanwhile, however, there is a growing problem with cirrhosis due to nonalcoholic fatty liver disease (NAFLD), specifically nonalcoholic steatohepatitis (NASH). NASH, which typically develops in the setting of obesity, type 2 diabetes, dyslipidemia, and hypertension, appears to lead the list of risk factors for HCC.

Tests and procedures used to diagnose hepatocellular carcinoma include: Blood tests to measure liver function. Imaging tests, such as CT and MRI. Liver biopsy, in some cases, to remove a sample of liver tissue for laboratory testing.

The prevention of the development of any liver diseases and of their progression to cirrhosis is the most effective way to prevent HCC. Symptoms often don’t appear in the early stages of the cancer. Later, symptoms include weight loss, upper abdominal pain or yellowing of the skin

Liver transplantation remains the best option for patients with HCC. Other treatments may include surgery, transplant, freezing or heating the cancer cells, radiofrequency ablation (RFA), potentially, systemic therapy with sorafenib and chemotherapy.

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