CANCER - LIVER
Definition
Hepatocellular carcinoma (HCC) is a primary malignancy of the hepatocyte, generally leading to death within 6-20 months. HCC frequently arises in the setting of cirrhosis, appearing 20-30 years following the initial insult to the liver. However, 25% of patients have no history or risk factors for the development of cirrhosis. The extent of hepatic dysfunction limits treatment options, and as many patients die of liver failure as from tumour progression. HCC is the fifth most common cancer in men and the eighth most common cancer in women worldwide. An estimated 560,000 new cases are diagnosed annually. The incidence of HCC worldwide varies according to the prevalence of hepatitis B and C infections. Areas such as Asia and sub-Saharan Africa with high rates of infectious hepatitis have incidences as high as 120 cases per 100,000.
Aetiology / Risk Factors
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History of infection with a hepatitis virus
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Alcoholic liver disease
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Chronic toxin exposure (e.g. aflatoxin)
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Haemochromatosis
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Obesity and NIDDM – mediated via the development of NASH (Non Alcoholic Steatotic Hepatitis)
Symptoms & Signs
Patients generally present with symptoms of advancing cirrhosis.