Liver cancer (hepatocellular carcinoma)
Also called: HCC, Hepatoma
The most common primary liver cancer, arising mostly in livers already damaged by cirrhosis or chronic hepatitis B. Surveillance ultrasound finds it early in at-risk people.
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Causes
- Cirrhosis of any cause
- Chronic hepatitis B (even without cirrhosis)
- Aflatoxin exposure
Risk factors
- Cirrhosis
- Hepatitis B and C
- Alcohol
- Fatty liver disease
- Diabetes
- Male sex
Symptoms
- Often none early
- Upper right abdominal pain
- Weight loss
- Worsening of cirrhosis (ascites, jaundice)
Diagnosis — tests and examinations
- Six-monthly ultrasound ± AFP in cirrhosis
- Multiphase CT or MRI (characteristic enhancement)
- Biopsy if imaging is not diagnostic
Treatment
Medicines and medical treatment
- Immunotherapy combinations (atezolizumab + bevacizumab, durvalumab + tremelimumab)
- Tyrosine kinase inhibitors (lenvatinib, sorafenib)
Operations and procedures
- Surgical resection
- Liver transplantation (Milan criteria)
- Radiofrequency or microwave ablation
- Transarterial chemoembolisation (TACE) or radioembolisation
Self-care, home remedies and lifestyle
- Abstain from alcohol
- Keep surveillance appointments
Possible complications
- Liver failure
- Rupture and bleeding
- Portal vein invasion
Prevention
- Hepatitis B vaccination, hepatitis C cure, avoid alcohol excess and obesity
Outlook
Early tumours are often curable; advanced disease is treatable but rarely curable.
When to see a doctor
People with cirrhosis or hepatitis B should have regular surveillance.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
Educational overview, not medical advice. Treatment varies by person and location. Consult a qualified health professional for diagnosis or care. Read our content and model notes and privacy information.