Liver cancer

Liver cancer
Other namesHepatic cancer, primary hepatic malignancy, primary liver cancer
CT scan of a liver with cholangiocarcinoma
SpecialtyGastroenterology Hepatology Oncology
SymptomsLump or pain in the right side below the rib cage, swelling of the abdomen, yellowish skin, easy bruising, weight loss, weakness[1]
Usual onset55 to 65 years old[2]
Causeshepatitis B, hepatitis C, alcoholism, aflatoxin, non-alcoholic fatty liver disease, liver flukes[3][4]
Diagnostic methodBlood tests, medical imaging, tissue biopsy[1]
PreventionImmunization against hepatitis B, treating those infected with hepatitis B or C,[3] decreasing exposure to aflatoxin, decreasing high levels of alcohol consumption
TreatmentSurgery, targeted therapy, radiation therapy[1]
PrognosisFive-year survival rates ~18% (US);[2] 40% (Japan)[5]
Frequency618,700 (point in time in 2015)[6]
Deaths782,000 (2018)[7]

Liver cancer, also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy, is cancer that starts in the liver.[1] Liver cancer can be primary in which the cancer starts in the liver, or it can be liver metastasis, or secondary, in which the cancer spreads from elsewhere in the body to the liver. Liver metastasis is the more common of the two liver cancers.[3] Instances of liver cancer are increasing globally.[8][9]

Primary liver cancer is globally the sixth-most frequent cancer and the fourth-leading cause of death from cancer.[7][10] In 2018, it occurred in 841,000 people and resulted in 782,000 deaths globally.[7] Higher rates of liver cancer occur where hepatitis B and C are common, including Asia and sub-Saharan Africa.[3] Males are more often affected with hepatocellular carcinoma (HCC) than females.[3] Diagnosis is most frequent among those 55 to 65 years old.[2]

The leading cause of liver cancer is cirrhosis due to hepatitis B, hepatitis C, or alcohol.[4] Other causes include aflatoxin, non-alcoholic fatty liver disease and liver flukes.[3] The most common types are HCC, which makes up 80% of cases and intrahepatic cholangiocarcinoma.[3] The diagnosis may be supported by blood tests and medical imaging, with confirmation by tissue biopsy.[1]

Given that there are many different causes of liver cancer, there are many approaches to liver cancer prevention. These efforts include immunization against hepatitis B,[3] hepatitis B treatment, hepatitis C treatment, decreasing alcohol use,[8] decreasing exposure to aflatoxin in agriculture, and management of obesity and diabetes.[9] Screening is recommended in those with chronic liver disease.[3] For example, it is recommended that people with chronic liver disease who are at risk for hepatocellular carcinoma be screened every 6 months using ultrasound imaging.[8]

Because liver cancer is an umbrella term for many types of cancer, the signs and symptoms depend on what type of cancer is present. Symptoms can be vague and broad. Cholangiocarcinoma is associated with sweating, jaundice, abdominal pain, weight loss, and liver enlargement.[11] Hepatocellular carcinoma is associated with abdominal mass, abdominal pain, vomiting, anemia, back pain, jaundice, itching, weight loss and fever.[12]

Treatment options may include surgery, targeted therapy and radiation therapy.[1] In certain cases, ablation therapy, embolization therapy or liver transplantation may be used.[1]

  1. ^ a b c d e f g "Adult Primary Liver Cancer Treatment (PDQ®)–Patient Version". NCI. 6 July 2016. Archived from the original on 2 October 2016. Retrieved 29 September 2016.
  2. ^ a b c "SEER Stat Fact Sheets: Liver and Intrahepatic Bile Duct Cancer". NCI. Archived from the original on 2017-07-28.
  3. ^ a b c d e f g h i World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.6. ISBN 978-9283204299.
  4. ^ a b Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. (GBD 2013 Mortality Causes of Death Collaborators) (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–171. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
  5. ^ "がん診療連携拠点病院等院内がん登録生存率集計：[国立がん研究センター がん登録・統計]". ganjoho.jp. Retrieved 2 February 2020.
  6. ^ Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  7. ^ a b c Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (November 2018). "Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries". CA. 68 (6): 394–424. doi:10.3322/caac.21492. PMID 30207593. S2CID 52188256.
  8. ^ a b c Bruix J, Han KH, Gores G, Llovet JM, Mazzaferro V (April 2015). "Liver cancer: Approaching a personalized care". Journal of Hepatology. 62 (1 Suppl): S144–S156. doi:10.1016/j.jhep.2015.02.007. PMC 4520430. PMID 25920083.
  9. ^ a b Mantovani A, Targher G (July 2017). "Type 2 diabetes mellitus and risk of hepatocellular carcinoma: spotlight on nonalcoholic fatty liver disease". Annals of Translational Medicine. 5 (13): 270. doi:10.21037/atm.2017.04.41. PMC 5515814. PMID 28758096.
  10. ^ Cite error: The named reference :13 was invoked but never defined (see the help page).
  11. ^ Cholangiocarcinoma at eMedicine
  12. ^ "Liver tumors in Children". Boston Children's Hospital. Archived from the original on 2011-06-04.