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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:
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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
|
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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.
Sign Up and See the Results Right Now
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).
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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.