Overview: Hepatocellular carcinoma – the future starts now

摘要

While hepatocellular cancer remains relatively uncommon in Australia, incidence rates have been progressively rising over the last few decades. Hepatocellular cancer has well-defined risk factors, some of them amenable to modulation or eradication. Currently, chronic hepatitis B or C infection accounts for approximately 80% of all primary liver cancers, but as hepatitis B vaccination will lead to fewer hepatitis B-related cancers, more cases will be due to hepatitis C or non-alcoholic fatty liver disease. Cancer control strategies are contingent upon the ability to prevent liver disease progression to cirrhosis and the eradication or suppression of viral replication; the extent to which screening improves disease-specific or all-cause mortality remains unclear. Our understanding of hepatocellular cancer biology and of viral hepatitis has dramatically increased in recent years, as a result of cross-disciplinary collaborations between clinicians, epidemiologists, public health practitioners and basic scientists. Hepatocellular cancer responds poorly to conventional chemotherapy, but the advent of new and more effective therapies –particularly biological agents that specifically target the molecular basis of neoplastic growth and metastasis – is expected to make a significant impact in coming years. We hope that this issue of Cancer Forum will convince the reader that we are now at the threshold of a better future for this previously untreatable malignancy.