Hepatocellular Carcinoma: Clinical Aspects

  • Chao H. Chan


Hepatocellular carcinoma is one of the most common malignancies worldwide. The incidence is particularly high in Africa and Asia.1–8 Accurate figures on the incidence of hepatocellular carcinoma are not available due to the inclusion of gallbladder carcinoma and cholangiocarcinoma as primary liver and biliary tract cancer.7, 9


Hepatocellular Carcinoma Gallbladder Carcinoma Biliary Tract Cancer Primary Liver Cancer Primary Hepatocellular Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Anthony PP: Primary carcinoma of the liver: A study of 282 cases in Ugandan Africans. J Pathol 110:37–48, 1973.PubMedCrossRefGoogle Scholar
  2. 2.
    Berman C: Primary carcinoma in the Bantu races of South Africa. S Afr J Med Sci. 5:54–72, 1960.Google Scholar
  3. 3.
    Geddes EW, Falkson G: Malignant hepatoma in the Bantu. Cancer 25:1271–1278, 1970.PubMedCrossRefGoogle Scholar
  4. 4.
    Steiner PE: Cancer of the liver and cirrhosis in Trans-Saharan Africa and the United States of America. Cancer 13:1085–1166, 1960.CrossRefGoogle Scholar
  5. 5.
    Tull JC: Primary carcinoma of the liver: A study of one hundred and thirty-four cases. J Pathol 35:557–562, 1932.CrossRefGoogle Scholar
  6. 6.
    Vogel CL, Anthony PP, Mody N, et al: Hepatitis-associated antigen in Ugandan patients with hepatocellular carcinoma. Lancet 2:621–624, 1970.PubMedCrossRefGoogle Scholar
  7. 7.
    Doll R, Payne P, Waterhouse J: Cancer Incidence in Five Continents. International Union Against Cancer and Springer-Verlag, Heidelberg, 1966.Google Scholar
  8. 8.
    Beasley RP, Hwang LY, Lin CC, et al: Hepatocellular carcinoma and hepatitis B virus. Lancet 2:1129–1132, 1981.PubMedCrossRefGoogle Scholar
  9. 9.
    American Cancer Society: Cancer Facts and Figures, American Cancer Society, New York, 1985.Google Scholar
  10. 10.
    Edmondson HA, Craig JR: Neoplasm of the liver, in Schiff L, Schiff E (eds): Disease of the Liver, 6th ed. JB Lippincott, Philadelphia, 1987, pp. 1109–1158.Google Scholar
  11. 11.
    Okuda K, Peters RL (eds): Hepatocellular Carcinoma. Wiley, New York, 1976.Google Scholar
  12. 12.
    Lutwick LI: Relationship between aflatoxins and hepatitis B virus and hepatocellular carcinoma. Lancet 1:755–757, 1979.PubMedCrossRefGoogle Scholar
  13. 13.
    Beasley RP: Hepatitis B virus as the etiologic agent in hepatocellular carcinoma—Epidemiologic considerations. Hepatology 2:21s–26s, 1982.Google Scholar
  14. 14.
    Kang LY: Epidemiology and prevention of viral hepatitis in China, in Proceedings of the 1986 Shanghai International Symposium on Liver Cancer and Hepatitis pp. 230-259.Google Scholar
  15. 15.
    Shafritz DA, Shouval D, Sherman HI, et al: Integration of hepatitis B virus DNA into the genome of liver cells in chronic liver disease and hepatocellular carcinoma. N Engl J Med 305:1067–1073, 1981.PubMedCrossRefGoogle Scholar
  16. 16.
    Brechot C, Degos F, Lugassy C, et al: Hepatitis B virus DNA in patients with chronic liver disease and negative tests for hepatitis B surface antigen. N Engl J Med 312:270–276, 1985.PubMedCrossRefGoogle Scholar
  17. 17.
    Omata M, Ashcavai M, Liew CT, et al: Hepatocellular carcinoma in the U.S.A. Etiologic considerations. Gastroenterology 76:279–287, 1979.PubMedGoogle Scholar
  18. 18.
    Tabor E, Gerety RJ, Vogel CL, et al: Hepatitis B virus infection and primary hepatocellular carcinoma. J Natl Cancer Inst 58:1197–1200, 1977.PubMedGoogle Scholar
  19. 19.
    Enwonwu CO: The role of dietary aflatoxin in the genesis of hepatocellular cancer in developing countries. Lancet 2:956–958, 1984.PubMedCrossRefGoogle Scholar
  20. 20.
    Busby WF, Wogan GN: Food-borne mycotoxins and alimentary mycotoxicoses, in Riemann H, Bryan FL (eds): Food-borne Infections and Intoxications. Academic, Orlando, Florida, 1979, pp. 519–610.Google Scholar
  21. 21.
    Linsell CA, Peers FG: Aflatoxin and liver cell cancer. Trans R Soc Trop Med Hyg 71:471–473, 1977.PubMedCrossRefGoogle Scholar
  22. 22.
    Yu SZ: Drinking water and primary liver cancer, in Proceedings of the 1986 Shanghai International Symposium on Liver Cancer and Hepatitis, pp. 260-278.Google Scholar
  23. 23.
    Report to Congress: Preliminary Assessment of Suspected Carcinogens in Drinking Water. U.S. Environmental Protection Agency, Washington, D.C., 1975.Google Scholar
  24. 24.
    Zaman SN, Melia WM, Johnson RD, et al: Risk factors in development of hepatocellular carcinoma in cirrhosis: Prospective study of 613 patients. Lancet 1:1357–1360, 1985.PubMedCrossRefGoogle Scholar
  25. 25.
    Bradbear RA, Bain C, Siskind V, et al: Cohort study of internal malignancy in genetic hemochromatosis and other chronic nonalcoholic liver diseases. J Natl Cancer Inst 75:81–84, 1985.PubMedGoogle Scholar
  26. 26.
    Chan CH: Primary carcinoma of the liver. Med Clin North Am 50:989–994, 1975.Google Scholar
  27. 27.
    Berg NO, Eriksson S: Liver disease in adults with alpha-l-antitrypsin deficiency. N Engl J Med 287:1264–1267, 1972.PubMedCrossRefGoogle Scholar
  28. 28.
    Wilkinson ML, Portmann B, Williams R: Wilson’s disease and hepatocellular carcinoma: possible protective role of copper. Gut 24:767–771, 1983.PubMedCrossRefGoogle Scholar
  29. 29.
    Hardell L, Bengtsson NO, Jonsson U, et al: Etiologic aspects of primary liver cancer with special regard to alcohol, organic solvents and acute intermittent porphyria—An epidemiological investigation. Br J Cancer 50:389–397, 1984.PubMedCrossRefGoogle Scholar
  30. 30.
    Faivre J, Milan C, Bugnon P, Legoux JL, et al: Primary liver cancer in Cote d’ Or (Burgundy). Results of three years systematic registration in a well-defined French population. Biomedicine 31:150–152, 1979.PubMedGoogle Scholar
  31. 31.
    Lee F: Cirrhosis and hepatoma in alcoholics. Gut 7:77–85, 1966.PubMedCrossRefGoogle Scholar
  32. 32.
    Leevy C, Gellene R, Ning M: Primary liver cancer in cirrhosis of the alcoholic. Ann NY Acad Sci 114:1026–1040, 1964.CrossRefGoogle Scholar
  33. 33.
    Ugarte G, Donoso S: Primary hepatic tumors in Chile, in Remmer H, Bolt HM, Bannasch P, et al (eds): Primary Liver Tumors, MTP Press, Lancaster, 1978, pp. 165–169.Google Scholar
  34. 34.
    Bassendine MF, Seta L, Salmerons J, et al: Incidence of hepatitis B virus infection in alcoholic liver disease. HBsAg negative chronic active liver disease and primary liver cell cancer in Britain. Liver 3:65–70, 1983.PubMedGoogle Scholar
  35. 35.
    Brechot C, Nalpas B, Courouce AM, et al: Evidence that hepatitis B virus has a role in liver cell carcinoma in alcoholic liver disease. N Engl J Med 306:1384–1387, 1982.PubMedCrossRefGoogle Scholar
  36. 36.
    Neuberger J, Portmann B, Nunnerley HB, et al: Oral contraceptive associated liver tumours: Occurrence of malignancy and difficulties in diagnosis. Lancet 1:273–276, 1980.PubMedCrossRefGoogle Scholar
  37. 37.
    Shar SR, Kew MC: Oral contraceptives and hepatocellular carcinoma. Cancer 409:407–410, 1982.CrossRefGoogle Scholar
  38. 38.
    Kiyosawa K, Akahane Y, Nagata A, et al: Hepatocellular carcinoma after non-A, non-B post-transfusion hepatitis. Am J Gastroenterol 79:777–781, 1984.PubMedGoogle Scholar
  39. 39.
    Resnick RH, Stone K, Antonioli D: Primary hepatocellular carcinoma following non-A, non-B post-transfusion hepatitis. Dig Dis Sci 28:908–911, 1983.PubMedCrossRefGoogle Scholar
  40. 40.
    Chan CH, Slaton D, Morrison D, et al: Hepatocellular carcinoma in Arkansas, clinical and epidemiologic features in 112 patients, (in preparation)Google Scholar
  41. 41.
    Chlebowski RT, Tong M, Weissman J, et al: Hepatocellular carcinoma: Diagnostic and prognostic features in North American patients. Cancer 53:2701–2706, 1984.PubMedCrossRefGoogle Scholar
  42. 42.
    Inouye AA, Whelan TJ Jr: Primary liver carcinoma: A review of 205 cases in Hawaii. Am J Surg 138:53–61, 1979.PubMedCrossRefGoogle Scholar
  43. 43.
    Ihde DC, Sherlock P, Winawer SJ, et al: Clinical manifestations of hepatoma: A review of 6 year’s experience at a cancer hospital. Am J Med 56:83–91, 1974.PubMedCrossRefGoogle Scholar
  44. 44.
    Kew MC: Clinical, pathologic and etiologic heterogeneity in hepatocellular carcinoma: Evidence from southern Africa. Hepatology 1:366–369, 1981.PubMedCrossRefGoogle Scholar
  45. 45.
    Margolis L, Homcy C: Systemic manifestations of hepatoma. Medicine (Baltimore) 51:381–391, 1972.Google Scholar
  46. 46.
    Soulier JP, Gozin D, Lefrere JJ: A new method to assay des-r-carboxyprothrombin. Gastroenterology 91:1258–1262, 1986.PubMedGoogle Scholar
  47. 47.
    Liebman HA, Furie BC, Tong MJ, et al: Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. N Engl J Med 310:1427–1431, 1984.PubMedCrossRefGoogle Scholar
  48. 48.
    Williamson BWA, Blumgart LH, McKellar NJ: Management of tumors of the liver, combined use of arteriography and venography in the assessment of resectability, especially in hilar tumors. Am J Surg 139:210–215, 1980.PubMedCrossRefGoogle Scholar
  49. 49.
    Proceedings of the 1986 Shanghai International Symposium on Liver Cancer and Hepatitis, pp. 1-171.Google Scholar
  50. 50.
    Ohishi H, Uchida H, Yoshimura H, et al: Hepatocellular carcinoma detected by iodized oil. Radiology 154:25–29, 1985.PubMedGoogle Scholar
  51. 51.
    Okuda K, Obata H, Nakajima Y, et al: Prognosis of primary hepatocellular carcinoma. Hepatology 4:3s–6s, 1984.PubMedCrossRefGoogle Scholar
  52. 52.
    Lee SD, Lo KJ, Wu JC, et al: Prevention of maternal-infant hepatitis B virus transmission by immunization: The role of serum hepatitis B virus DNA. Hepatology 6:369–373, 1986.PubMedCrossRefGoogle Scholar
  53. 53.
    Blumberg BS, London WT: Hepatitis B virus and the prevention of primary cancer of the liver. J Natl Cancer Inst 71:213–261, 1985.Google Scholar
  54. 54.
    Heyward WL, Lanier AP, McMahon BJ, et al: Early detection of primary hepatocellular carcinoma. JAMA 254:3052–3054, 1985.PubMedCrossRefGoogle Scholar
  55. 55.
    Kobayashi K, Sugimoto T, Makino H, et al: Screening methods for early detection of hepatocellular carcinoma. Hepatology 5:1100–1105, 1985.PubMedCrossRefGoogle Scholar
  56. 56.
    Liaw YF, Tai DI, Chu CM, et al: Early detection of hepatocellular carcinoma in patients with type B hepatitis. Gastroenterology 90:263–267, 1986.PubMedGoogle Scholar
  57. 57.
    Ebara M, Ohto M, Shinagawa T, et al: Natural history of minute hepatocellular carcinoma smaller than three centimeters complicating cirrhosis. Gastroenterology 90:289–298, 1986.PubMedGoogle Scholar
  58. 58.
    Tang Z-Y (ed): Subclinical Hepatocellular Carcinoma. China Academic Publishers, Beijing-Springer-Verlag, Berlin, 1985.Google Scholar
  59. 59.
    Sheu JC, Sung JL, Chen DS, et al: Early detection of hepatocellular carcinoma by real-time ultrasonography. Cancer 56:660–666, 1985.PubMedCrossRefGoogle Scholar
  60. 60.
    Sheu JC, Sung JL, Chen DS: Growth rate of asymptomatic hepatocellular carcinoma and its clinical implications. Gastroenterology 89:259–266, 1985.PubMedGoogle Scholar
  61. 61.
    Cady B, Macdonald JS, Gunderson LL: Cancer of the hepatobiliary system, in Devita VT Jr, Hellman S, Rosenberg SA (eds): Cancer, Principles and Practice of Oncology, 2nd ed. JB Lippincott, Philadelphia, 1985, pp. 747–753.Google Scholar
  62. 62.
    Lighdsdale CJ, Daly J: Management of primary and metastatic cancer of the liver, in Devita VT Jr, Hellman S, Rosenberg SA (eds): Cancer, Principles and Practice of Oncology, 2nd ed. JB Lippincott, Philadelphia, 1985, pp. 1159–1170.Google Scholar
  63. 63.
    Cuervas-Mons V, Martinez AJ, Dekker A, et al: Adult liver transplantation: An analysis of early causes of death on 40 consecutive cases. Hepatology 6:495–501, 1986.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Chao H. Chan
    • 1
    • 2
  1. 1.Gastroenterology DivisionUniversity of Arkansas for Medical SciencesUSA
  2. 2.John L. Mc-Clellan Memorial Veterans Administration Medical CenterLittle RockUSA

Personalised recommendations