Hepatocellular Carcinoma

Hepatocellular carcinoma is the third most frequent cause of death from cancer worldwide. This cancer is most common in geographic regions with a high prevalence of chronic hepatitis B virus infection-particularly in Asia and sub-Saharan Africa. However, due to increased incidence of chronic hepatitis C virus infection between 1945 and 1990, the incidence rates of hepatocellular carcinoma have been increasing in Europe and North America since the 1970s. Substantial advances have been made in therapy of hepatocellular carcinoma, notably the recognition that in patients with early stage disease liver transplantation can achieve a 5-year survival of over 70%. These results, along with advances in surgical resection, local ablation, and locoregional therapies, have led to an increased emphasis on surveillance of individuals at risk for hepatocellular carcinoma, to allow for early diagnosis and more effective treatment of as many patients as possible. For patients with advanced, unresectable disease, the recent FDA approval of the multikinase inhibitor sorafenib, which has been shown to moderately extend patient survival, is a positive harbinger for future advances in therapy.