Changes to This Summary (10/31/2011)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Adult Primary Liver Cancer ¹

Updated statistics ² with estimated new cases and deaths for 2011 (cited American Cancer Society as reference 1).

Added text ³ to state that in the United States, obesity has emerged as a very important risk factor for hepatocellular carcinoma and is the main contributor of nonalcoholic steatohepatitis, which may be related to an increase in the rate of hepatocellular carcinoma (cited El-Serag as reference 12).

Stage Information for Adult Primary Liver Cancer ⁴

Added text ⁵ to state that patients with cirrhosis and resectable tumors are also eligible for liver transplantation (cited Mazzaferro et al. as reference 1), and if eligible, sometimes other measures are instituted until liver transplantation becomes available.

Added Llovet et al., 2005 Bruix et al., and 2001 Bruix et al. as references 2, 3, and 4, ⁶ respectively. Also revised text ⁶ to state that for other patients, percutaneous or intraoperative radiofrequency ablation or other forms of ablation of small appropriately located tumors, or transarterial chemoembolization (TACE) may be options (cited Pawlik et al. as reference 5).

Localized and Locally Advanced Unresectable Adult Primary Liver Cancer ⁷

Revised text ⁸ of systemic chemotherapy treatment option to systemic chemotherapy and/or targeted therapy and added text about pre-SHARP trial data. Also added that the SHARP trial assigned 602 patients with advanced hepatocellular carcinoma who had not received prior systemic treatment to receive either sorafenib 400 mg twice daily or placebo and that all but 20 patients had Childs-Pugh A liver disease score; 13% were women, and after 321 deaths, the median survival was significantly longer in the sorafenib group (cited Llovet et al. as reference 14 and level of evidence 1iA). Added that while median time to symptoms was not significantly different, the percent achieving radiologic responses was higher in the sorafenib group.

Added text ⁹ to state that a subsequent trial conducted with 271 patients from 23 centers in China, South Korea, and Taiwan with a 2:1 randomization on sorafenib achieved an overall median survival rate of 6.5 months on sorafenib versus 4.2 months on placebo (cited Cheng et al. as reference 15). Also added that adverse events attributed to sorafenib in both of these trials included hand-foot skin reactions and diarrhea.

Added text ¹⁰ to state that these studies establish a role for sorafenib in locally advanced as well as advanced hepatocellular cancers extending beyond the liver, which are not amenable to regional modalities; studies are ongoing to evaluate the role of sorafenib after TACE, with chemotherapy, or in the presence of more advanced liver disease.