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Hepatocellular Carcinoma (Comprehensive Review)

Primary Liver Cancer Arising in Cirrhotic and Non-Cirrhotic Liver

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Hepatocellular Carcinoma (Comprehensive Review)?

Hepatocellular carcinoma (HCC) accounts for 90% of primary liver cancers and is the third leading cause of cancer-related death globally.

It typically develops on a background of chronic liver disease and cirrhosis, though increasing cases arise in non-cirrhotic livers from MASH (metabolic dysfunction-associated steatohepatitis).

Staging integrates tumor burden, liver function (Child-Pugh), and performance status — most commonly using the Barcelona Clinic Liver Cancer (BCLC) system to guide therapy.

Symptoms

Often asymptomatic in early stages — detected by surveillance
Right upper quadrant pain or fullness
Ascites, lower extremity edema in advanced disease
Jaundice from portal vein invasion or hepatic decompensation
Weight loss, anorexia, early satiety
Paraneoplastic syndromes: hypoglycemia, polycythemia, hypercalcemia
Acute hemoperitoneum from tumor rupture (rare emergency)

Risk Factors

Chronic hepatitis B (most common globally)
Chronic hepatitis C with cirrhosis
Alcohol-related liver disease and cirrhosis
Metabolic dysfunction-associated steatohepatitis (MASH/NASH)
Hereditary hemochromatosis, alpha-1 antitrypsin deficiency, Wilson disease
Aflatoxin exposure
Type 2 diabetes mellitus, obesity
Family history and certain genetic backgrounds

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Cirrhotic patient missing surveillance ultrasound and AFP every 6 months
  • New right upper quadrant pain or weight loss in chronic liver disease
  • Rising AFP or new liver mass on imaging
  • Decompensation in known cirrhosis (ascites, encephalopathy, bleeding)
  • Suspicious nodule on imaging requiring multidisciplinary tumor board

Treatment Methods

01
Surgical resection for solitary tumors with preserved liver function
02
Liver transplantation within Milan criteria (single tumor under 5 cm or up to 3 tumors under 3 cm) — best curative option in advanced cirrhosis
03
Local ablation: radiofrequency ablation, microwave ablation, percutaneous ethanol injection
04
Transarterial chemoembolization (TACE) for intermediate stage
05
Transarterial radioembolization (TARE/Y-90) for select intermediate/advanced cases
06
First-line systemic: atezolizumab + bevacizumab; durvalumab + tremelimumab
07
Second-line: lenvatinib, sorafenib, regorafenib, cabozantinib, ramucirumab
08
Best supportive care for Child-Pugh C with poor performance status
09
Treatment of underlying liver disease: antiviral therapy, alcohol cessation, metabolic management

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.