Liver cancer is the second most common cause of cancer-related death. The major forms of primary liver cancer are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA). Both these tumors develop against a background of cirrhotic liver, non-alcoholic fatty liver disease, chronic liver damage and fibrosis. HCC is a heterogeneous disease which usually develops within liver cirrhosis related to various etiologies: hepatitis B virus (HBV) infection (frequent in Asia and Africa), hepatitis C virus (HCV), chronic alcohol abuse, or metabolic syndrome (frequent in Western countries). In cirrhosis, hepatocarcinogenesis is a multi-step process where pre-cancerous dysplastic macronodules transform progressively into HCC.
Colorectal liver metastasis (CRC) is an increasing global health issue. It is the most common gastro-intestinal tumor and the third most frequently diagnosed malignancy worldwide.
The liver is recognized as the most common site of CRC metastasis because the majority of the intestinal mesenteric drainage enters the hepatic portal venous system.
Signs and symptoms of liver cancer often do not show up until the later stages of the disease, but sometimes they may show up sooner. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed earlier, when treatment is most likely to be helpful. Some of the most common symptoms of liver cancer are:
Weight loss (without trying)
Loss of appetite
Feeling very full after a small meal
Nausea or vomiting
An enlarged liver, felt as a mass under the ribs on the right side
An enlarged spleen, felt as a mass under the ribs on the left side
Pain in the abdomen or near the right shoulder blade
Swelling or fluid build-up in the abdomen
Yellowing of the skin and eyes (jaundice)
Some other symptoms can include fever, enlarged veins on the belly that can be seen through the skin, and abnormal bruising or bleeding.
Common treatments for cancer are:
Surgery, also known as hepatectomy
Thermal and non-thermal ablation therapies
Surgical resection combined with Chemotherapy or Radiation is widespread globally but minimally invasive ablation procedures have become popular as for tumors up to 3cm the results are the equivalent to surgery.
The goal of Radiofrequency Ablation (RFA) is to completely destroy a tumor with minimal damage to surrounding liver tissue by inducing thermal injury to the tissue through electromagnetic energy deposition. RFA can be effective for both types of liver tumors: hepatocellular carcinoma (HCC) and liver metastases (CRC)
RFA has the advantage of being a relatively low-risk minimally invasive procedure for the treatment of focal liver tumors.
Castelli G, Pelosi E, Testa U. Liver Cancer: Molecular Characterization, Clonal Evolution and Cancer Stem Cells. Cancers. 2017
Zarour LR, Anand S, Billingsley KG, et al. Colorectal Cancer Liver Metastasis: Evolving Paradigms and Future Directions. Cellular and Molecular Gastroenterology and Hepatology. 2017