Hepatocellular carcinoma: An update

Hepatocellular carcinoma (HCC) is the fifth most common malignancy in men and the eighth in women worldwide, accounting for nearly 1 million deaths annually. Its incidence has increased nearly 75% during the past decade in the United States, and HCC is now recognized as an all too frequent complication of chronic liver disease. Chronic infection with the hepatitis B (HBV) or hepatitis C virus (HCV) is most frequently implicated in HCC, although other etiologies of cirrhosis, including alcohol and hemochromatosis, also have an increased risk. The prognosis for HCC is poor, with a 5-year survival of only 6% after diagnosis. Screening and early detection are important, because surgical resection or liver transplantation offer the only chances for long-term survival. For patients in whom surgical treatment is not an option because of advanced disease or comorbidities, newer modalities are being studied.