Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) usually arises in patients with cirrhosis of the liver due to any cause.

A significant number of patients may be asymptomatic and are diagnosed following screening.

Patients at risk of HCC should receive surveillance with an ultrasound of the liver at 6-month intervals.

Treatment is guided by staging and prognosis. Treatment options include resection, transplantation, percutaneous ablation therapy, and chemoembolization.

Sorafenib and lenvatinib are the only targeted first-line agents for advanced-stage HCC. Regorafenib, nivolumab, pembrolizumab, and cabozantinib are prescribed second-line for patients who progress on sorafenib.

Ramucirumab is approved for advanced or unresectable HCC in patients who have an alpha fetoprotein level ≥400 nanograms/mL and have been previously treated with sorafenib.

Hepatocellular carcinoma (HCC), also known as hepatoma, is a primary cancer arising from hepatocytes in predominantly cirrhotic liver. However, some patients may not have cirrhosis before developing HCC, especially patients with chronic hepatitis B virus.