Over the past three decades, the incidence of primary liver cancer (hepatocellular carcinoma and cholangiocarcinoma) in the U.S. has increased significantly. The increase in hepatocellular carcinoma has been driven largely by the hepatitis C epidemic, although the cirrhosis due to other causes including hepatitis B, alcoholism, and fatty liver disease can also predispose patients to the development of hepatocellular carcinoma. Cholangiocarcinoma occurs in the setting of chronic biliary tract disease including primary sclerosing cholangitis and biliary obstruction.
Both hepatocellular carcinoma (HCC) and cholangiocarcinoma are often "silent" in the early stages, and many patients do not exhibit symptoms until their disease is advanced and difficult to treat. The best chance for cure is early diagnosis through screening for HCC in high risk populations, including all patients with cirrhosis and those patients with chronic active viral hepatitis, and periodic reassessment of patients at high risk for cholangiocarcinoma.
Once identified, the best hope for a long term cure is an aggressive approach to treatment. Because primary liver tumors frequently occur in patients with complex co-morbid conditions, an integrated multidisciplinary approach to care is vital. Through the use of new techniques and intensive treatment, patients with primary liver tumors can experience long term survival and may even be cured. The Interdisciplinary Liver Tumor Clinic offers state-of-the-art care for this important and increasing population of patients.