Liver Cancer

Hepatocellular carcinoma (HCC) is the second most common cause of cancer death in the world, and prognosis remains poor. HCC accounts for more than 90% of primary liver cancer, and the main risk factor for its development is liver cirrhosis of any etiology, most commonly viral hepatitis. Clinical presentation is variable, and patients may remain asymptomatic for a long time, presenting with symptoms only when the disease is advanced. When diagnosed at an early stage, it is usually incidental or when patients with cirrhosis are on a surveillance program. Imaging is the cornerstone in diagnosis, management and follow-up of these patients. Various staging systems and treatment algorithms have been developed worldwide. Curative treatments include resection, transplantation and ablation, while palliative treatments include TACE and Sorafenib. The prognosis of advanced untreated HCC is dismal with a median survival of 8 months. Prognosis in general depends on whether curative treatment can be given, which is in turn dependent on the tumor burden, liver function and the patient’s performance status. Curative treatment is associated with a 5-year survival of 40–70%.