Hepatocellular carcinoma. A concise guide to its status and management.

Although common worldwide, hepatocellular carcinoma is relatively rare in the United States. However, for unknown reasons, the incidence is rising. Multiple causes exist, but chronic viral hepatitis in the setting of cirrhosis is probably the most common. Despite limitations, AFP measurement and multiple-phase abdominal CT are the most sensitive tests for diagnosis. Surgical resection and liver transplantation are at present the only treatment options that offer potential for long-term survival or cure in limited-stage hepatocellular carcinoma. Otherwise, the prognosis is poor, and 1-year survival is rare. Future efforts should focus on improving detection of early-stage disease and improving preventive measures to reduce viral hepatitis infection, transmission, and progression.