Hepatocellular carcinoma is one of the major
cancer killers. It affects patients with chronic
liver disease who have established
cirrhosis, and currently is the most frequent cause of death in these patients. The main risk factors for its development are
hepatitis B and C
virus infection,
alcoholism and
aflatoxin intake. If acquistion of risk factors is not prevented and
cirrhosis is established, the sole option to improve survival is to detect the
tumor at an early stage when effective
therapy may be indicated. Early detection plans should be based on hepatic ultrasonography every 6 months, whereas determination of
tumor markers is not efficient. Upon detection of a hepatic nodule, there is a need to establish unequivocal diagnosis, either through biopsy or through the application of non-invasive criteria based on the specific radiology appearance of the
tumor: fast arterial uptake of contrast followed by venous washout. Effective treatment for
liver cancer includes surgical resection,
liver transplantation and percutaneous ablation. These options provide a high rate of complete responses and are assumed to improve survival that should exceed 50% at 5 years. If the
tumor is diagnosed at an advanced stage, the sole option that improves survival is transarterial chemoembolization. Ongoing research should further advance the time at diagnosis and identify new and effective options targeting molecular pathways governing
tumor progression.