Liver cancer

About liver cancer

The most common type is hepatocellular carcinoma (HCC), which usually develops in a liver damaged by chronic hepatitis B or C, alcohol or fatty liver disease. Because hepatitis B has long been common in China, Chinese hospitals see very large numbers of HCC patients at every stage.

Symptoms

Early liver cancer often causes no symptoms. Later signs include pain in the upper right abdomen, weight loss, loss of appetite, jaundice (yellow skin or eyes) and swelling of the abdomen. People with cirrhosis or chronic hepatitis are usually advised to have regular ultrasound and AFP blood tests.

Diagnosis

Diagnosis is based on multiphase CT or MRI, the AFP tumor marker and, when needed, a biopsy. Doctors then stage the cancer and assess liver function, which together determine the treatment options.

Treatment in China

• Surgery. Liver resection, including laparoscopic and robotic techniques, is the main curative option for suitable patients.
• Liver transplantation. Zhongshan Hospital’s team proposed the “Shanghai–Fudan criteria” for selecting liver cancer patients for transplantation.
• Local therapies. Radiofrequency or microwave ablation, transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC), which Chinese centers have developed extensively.
• Drug treatment. Targeted therapies and immunotherapy combinations, including several drugs developed and approved in China.
• Radiotherapy. Stereotactic radiotherapy, and proton or carbon-ion therapy for selected tumors.

Why patients choose China

High patient volumes give Chinese liver surgeons deep experience with complex resections and with tumors that invade the portal vein, a situation more common in hepatitis B–related HCC. Multidisciplinary tumor boards at top centers review each case before treatment.