LIVER (PRIMARY HEPATOCELLULAR-HCC)-CHILD

Primary liver cancer is also called hepatocellular carcinoma (HCC) or hepatoma. It may surprise you to know that while HCC is relatively uncommon in the United States, it is in fact the most common form of cancer in the world. It is especially prevalent in Asia and Africa. There are about one million new cases per year worldwide. In the U.S. there are about 15,000 new cases, including the closely related cancers of the gall bladder and/or bile ducts. Each year in the USA there are about 12,500 deaths from this disease.

The incidence rate worldwide ranges from a low of 0.8 per 100,000 among British women to an astonishing 112.9 among men in Mozambique. The reasons for the geographic variation in incidence are complex. Certainly, exposure to a type of mold called aflatoxin in food is one common cause in Africa and Asia. Chemical exposures (for example, vinyl chloride) may also play a part. But the strongest correlate of hepatocellular carcinoma incidence is the level of hepatitis B and C infection in a population. 

Damage to the liver over a long period of time is the main predisposing factor in the development of primary liver cancer. This damage can occur in several ways, but infection with hepatitis B or C - and particularly simultaneous infection with both B and C - is strongly associated with later development of hepatocellular carcinoma. Such damage often expresses itself in a degenerative condition of the liver, called cirrhosis, which predisposes to the development of primary liver cancer: 50-80 percent of patients with HCC have cirrhosis. (Cirrhosis can be also be caused by a variety of factors other than viral infection, including chronic alcohol abuse, exposure to environmental toxins, and genetic mutations.) 

It is important to understand the difference between primary liver cancer and so-called secondary liver cancer. Primary liver cancer arises within the liver itself. By contrast, secondary liver cancer is cancer that has spread to the liver from elsewhere - that is, from a tumor somewhere else in the body. (Spread from a distant tumor site to the liver and elsewhere in the body is called 'metastasis'). Many, many different kinds of tumor can spread to the liver by metastasis, but the tumors that end up growing in the liver as a result of metastasis are not primary liver cancers. Only tumors that arise out of the tissues of the liver itself, as a result of changes in the tissues and cells of the liver, are called primary liver cancers. Of course primary liver cancer itself can spread elsewhere, mainly to the lungs or the bones.