Hepatocellular Cancer

This chapter provides answers to practice-based questions with case studies covering the new principles of diagnosis, classification, staging, treatment, and outcomes in the rapidly advancing field of hepatocellular cancer. Liver cancer is the leading cancer in transitioned countries, including those of eastern Asia, southeastern Asia, and northern and western Africa. Multiple risk factors are related to the development of the disease, most commonly hepatitis B virus (HBV), hepatitis C virus, alcohol abuse, and metabolic syndrome. Around half of the cases of hepatocellular carcinoma in the world are related to chronic HBV. Patients may present with paraneoplastic syndrome of hypoglycemia, hypercalcemia, erythrocytosis and dermatomyositis. Most patients with metastatic HCC will die from the disease within one to two years irrespective of treatment received. Transarterial treatments can reduce the dropout rates for patients on liver transplantation waiting lists and decrease the risk of tumor progression.