Liver Cancer Overview

What is Hepatocellular Carcinoma (HCC)?

Hepatocellular carcinoma (often abbreviated "HCC"), also known as hepatoma, is the fifth most common cancer in the world, and has been increasing in prevalence in the United States, primarily because of the increased number of people with cirrhosis of the liver due to hepatitis C infection. HCC is a cancer of the hepatocyte, which is one of the main functional cell types in the liver.

HCC at a Glance

• HCC is the fifth most common cancer in the world.
• Many patients with HCC do not develop symptoms until the advanced stages of the tumor.
• Some liver diseases, most notably hepatitis B infection, can cause HCC even in the absence of cirrhosis.
• The combination of an imaging study (Ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein most effectively diagnoses HCC.
• In the U.S., patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing HCC.
• Patients with chronic liver disease (e.g., HCV, HBV, or hemochromatosis) should avoid drinking alcohol, which can further increase their risk of developing cirrhosis and HCC.
• Surgical resection (removal) of the tumor may be very effective for a select group of individuals with HCC, specifically for those with small tumors and excellent liver function.
• For patients with small HCC and significant associated liver disease, liver transplantation offers the best chance for cure.

What's the difference between HCC and other liver cancer?

There are several different types of liver cancer. HCC is a primary liver cancer that originates from liver cells. This most often occurs in people who have chronic liver disease and cirrhosis. HCC should be distinguished between other forms of liver cancer, such as metastatic tumor (cancers that have spread to the liver from another primary site, such as the lung or breast). Other, less common, types of primary liver cancers include:

• Cholangiocarcinomas (cancer of the bile ducts)
• Adenocarcinomas (other glands within the liver)
• Sarcomas and angiosarcomas (connective tissue within the liver)
• Hemangioendotheliomas (blood vessels within the liver)

What is fibrolamellar carcinoma?

Fibrolamellar carcinoma is a variation of HCC that is found in non-cirrhotic livers, usually in younger patients between the ages of 20 and 40 years. In fact, these patients have no associated liver disease and no risk factors have been identified. The alpha-fetoprotein in these patients is usually normal. The appearance of fibrolamellar carcinoma under the microscope is quite characteristic. That is, broad bands of scar tissue are seen running through the cancerous liver cells. The important thing about fibrolamellar carcinoma is that it has a much better prognosis than the common type of HCC. Thus, even with a fairly extensive fibrolamellar carcinoma, a patient can have a successful surgical removal.