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Cancer
 
Liver Cancer

The Cancer Monthly database currently has the results (survival, side effects, and more) for 15 recent therapies for liver cancer including immunotherapy, hormone therapy, chemotherapy, radiation, and alternative therapy.

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Introduction

Hepatocellular carcinoma (HCC) is one of the most common tumors in the world and the third most frequent cause of cancer deaths. It is more prevalent in Asia and Africa than in the U.S. or Western Europe. HCC is four times more common in men than in women and studies in Asia have demonstrated that the risk of HCC is 100 times greater in persons who have a history of hepatitis B infection.

The most common symptoms of HCC are abdominal pain with detection of an abdominal mass in the upper right quadrant. Imaging procedures to detect liver tumors include ultrasound, CT, MRI, and hepatic artery angiography.

 

Staging and Prognosis

Staging of HCC is based on four criteria: tumor size, presence of ascites, and bilirubin and albumin levels. The Okuda staging symptom is:

Grade
Criteria
Natural History Without Treatment
I
no positive criteria
8 months
II
1 or 2 positive
2 months
III
3 or 4 positive
Less than 1 month

Treatment

When cancers are detected before symptoms appear surgery alone can provide survival rates of 28% at 3 years. The course of clinically apparent disease is rapid if untreated. In selected cases, therapy may prolong life.

Treatment options include liver transplantation, hepatic artery embolization and chemotherapy (also called chemoembolization), radiofrequency ablation, and cryoablation. For potentially respectable HCC the 5 year survival rate can be over 50%. However, even after "curative" resection of HCC, the predisposing primary liver disorder (e.g. cirrhosis, hepatitis B) persists and new cancers can arise in the residual liver.

Treatment options for unresectable disease are limited. The liver cannot tolerate doses of radiation and the disease is not responsive to chemotherapy. Immunotherapy, biological therapy, and gene therapy techniques are being tested.

Treatment Results

The Cancer Monthly database currently has the results (survival, side effects, etc.) for 15 recent therapies for liver cancer including immunotherapy, hormone therapy, chemotherapy, radiation, and alternative therapy.

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Source: Jules L. Dienstag and Kurt J. Isselbacher, Tumors of the Liver and Biliary Tract, in HARRISON'S PRINCIPLES OF INTERNAL MEDICINE, pt. 5 § 78, at 533-536 (Dennis L. Kasper, M.D. et al., eds, 16th ed 2005).