Hepatocellular carcinoma is malignancy that originates from the liver.

Physical signs are hepatomegaly and ascites. It is usually asymptomatic for much of its natural history.

Liver cancer is the second most common cause of cancer-related mortality worldwide & hepatocellular carcinoma accounts for >90% of liver cancers.



  • Multiphasic cross-sectional imaging (eg CT or MRI) is the preferred method for surveillance following treatment due to its reliability in assessing arterial vascularity that is associated w/ increased risk of hepatocellular carcinoma recurrence following treatment
    • Test should be done every 3-6 months for 2 years, then every 6-12 months 
  • Serum alpha-fetoprotein (AFP) levels are associated w/ poor prognosis following treatment & should be measured every 3-6 months for 2 years, then every 6-12 months
  • In the event of disease recurrence, re-evaluation according to the initial work-up should be considered
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Christina Lau, 09 Oct 2019

Nivolumab, used in the first-line treatment of patients with advanced hepatocellular carcinoma (HCC), has demonstrated clinically meaningful improvements in overall survival (OS) and response rates vs sorafenib in the phase III CheckMate 459 study, although the improvement in OS did not reach statistical significance.