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Hepatocellular carcinoma natural history

Introduction

Overview

Overview

Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor. If the cancer is inoperable, the disease is usually deadly within 3 to 6 months. The survival rate of hepatocellular carcinoma is less than 50 percent.

Natural History

Natural History

Without treatment, the patient will develop symptoms of jaundice, ascites, cachexia, right upper quadrant abdominal pain, nausea, and vomiting, which will eventually lead to death.

Complications

Complications

Complications that can develop as a result of hepatocellular carcinoma include the following:

The following complications may result from TAE/TACE therapy of the tumour:[1][2][3][4]

Common complications of radiofrequency ablation therapy include the following:[5]

Prognosis

Prognosis

Due to its late presentation, the prognosis of hepatocellular carcinoma is poor even with treatment. Without treatment, hepatocellular carcinoma will result in early death. The prognosis depends on the following:[6]

The survival rate of Hepatocellular carcinoma is less than 50 percent.

Independent predictors of prognosis

Prognosis based on staging systems

  • The Barcelona Clinic Liver Cancer (BCLC) staging system has the best independent predictive power for survival when compared with the other 6 prognostic systems.[7]
References

References

  1. ↑ Tu J, Jia Z, Ying X, Zhang D, Li S, Tian F, Jiang G (2016). “The incidence and outcome of major complication following conventional TAE/TACE for hepatocellular carcinoma”. Medicine (Baltimore). 95 (49): e5606. doi:10.1097/MD.0000000000005606. PMCΒ 5266057. PMIDΒ 27930585.
  2. ↑ Jia Z, Tian F, Jiang G (2013). “Ruptured hepatic carcinoma after transcatheter arterial chemoembolization”. Curr Ther Res Clin Exp. 74: 41–3. doi:10.1016/j.curtheres.2012.12.006. PMCΒ 3862201. PMIDΒ 24384870.
  3. ↑ Chung JW, Park JH, Im JG, Han JK, Han MC (1993). “Pulmonary oil embolism after transcatheter oily chemoembolization of hepatocellular carcinoma”. Radiology. 187 (3): 689–93. doi:10.1148/radiology.187.3.8388567. PMIDΒ 8388567.
  4. ↑ Chung JW, Park JH, Han JK, Choi BI, Han MC, Lee HS, Kim CY (1996). “Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization”. Radiology. 198 (1): 33–40. doi:10.1148/radiology.198.1.8539401. PMIDΒ 8539401.
  5. ↑ Rhim H (2005). “Complications of radiofrequency ablation in hepatocellular carcinoma”. Abdom Imaging. 30 (4): 409–18. doi:10.1007/s00261-004-0255-7. PMIDΒ 15688113.
  6. ↑ Altekruse, Sean F.; McGlynn, Katherine A.; Reichman, Marsha E. (2009). “Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005”. Journal of Clinical Oncology. 27 (9): 1485–1491. doi:10.1200/JCO.2008.20.7753. ISSNΒ 0732-183X.
  7. ↑ 7.0 7.1 Marrero JA, Fontana RJ, Barrat A, Askari F, Conjeevaram HS, Su GL, Lok AS (2005). “Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort”. Hepatology. 41 (4): 707–16. doi:10.1002/hep.20636. PMIDΒ 15795889.


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2] Mohamad Alkateb, MBBCh [3]