Hepatocellular carcinoma: a review.

Area of Science:

• Hepatology and Oncology
• Cancer Epidemiology
• Liver Disease Research

Background:

• Hepatocellular carcinoma (HCC) is the most common primary liver cancer globally and a leading cause of cancer mortality.
• Despite advancements in diagnosis and treatment, HCC incidence and mortality rates are increasing, particularly in the United States.
• Cirrhosis is the primary risk factor for HCC, with hepatitis B, hepatitis C, and alcohol consumption being significant contributors.

Approach:

• Screening for HCC involves regular intervals of imaging tests (ultrasound, CT, MRI) and serological markers like alpha-fetoprotein.
• Diagnosis is often confirmed without pathological confirmation.
• Treatment selection depends on tumor characteristics (size, location, spread) and liver function, with orthotopic liver transplantation (OLT) or surgical resection offering curative potential.

Key Points:

• Orthotopic liver transplantation (OLT) and surgical resection are the only curative treatments for HCC.
• Various non-curative treatment modalities include chemoembolization, ablation techniques, radiation therapy, and systemic therapies.
• Preventive measures such as hepatitis B vaccination, safe practices, and antiviral therapy are vital for reducing HCC incidence.

Conclusions:

• HCC is an aggressive cancer often diagnosed at advanced stages, necessitating comprehensive management strategies.
• While OLT offers the best chance for cure, organ scarcity limits its application.
• Continued improvements in both surgical and nonsurgical treatments are enhancing overall survival rates for HCC patients.