A global view of hepatocellular carcinoma: trends, risk, prevention and management

Ju Dong Yang, Pierre Hainaut, Gregory J. Gores, Amina Amadou, Amelie Plymoth, Lewis R. Roberts

Research output: Contribution to journalReview articlepeer-review

318 Scopus citations

Abstract

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Risk factors for HCC include chronic hepatitis B and hepatitis C, alcohol addiction, metabolic liver disease (particularly nonalcoholic fatty liver disease) and exposure to dietary toxins such as aflatoxins and aristolochic acid. All these risk factors are potentially preventable, highlighting the considerable potential of risk prevention for decreasing the global burden of HCC. HCC surveillance and early detection increase the chance of potentially curative treatment; however, HCC surveillance is substantially underutilized, even in countries with sufficient medical resources. Early-stage HCC can be treated curatively by local ablation, surgical resection or liver transplantation. Treatment selection depends on tumour characteristics, the severity of underlying liver dysfunction, age, other medical comorbidities, and available medical resources and local expertise. Catheter-based locoregional treatment is used in patients with intermediate-stage cancer. Kinase and immune checkpoint inhibitors have been shown to be effective treatment options in patients with advanced-stage HCC. Together, rational deployment of prevention, attainment of global goals for viral hepatitis eradication, and improvements in HCC surveillance and therapy hold promise for achieving a substantial reduction in the worldwide HCC burden within the next few decades.

Original languageEnglish (US)
Pages (from-to)589-604
Number of pages16
JournalNature Reviews Gastroenterology and Hepatology
Volume16
Issue number10
DOIs
StatePublished - Oct 1 2019

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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