Liver cancer

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Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

There are several types of liver cancer, depending on the category of cells from which it develops: 

  • Hepatocellular carcinoma, the most common liver cancer, which develops from hepatocytes
  • Cholangiocarcinoma, a rare tumor affecting the bile ducts
  • Angiosarcoma, attacking the blood vessels, occurring after repeated exposure (especially occupational) to certain toxic products.
  • Fibrolamellar carcinoma, which starts in hepatocytes.

Hepatocellular carcinoma

Hepatocellular carcinoma mainly develops in people with chronic liver damage, such as cirrhosis

Therefore, the main risk factors for hepatocellular carcinoma are cirrhosis, but also chronic viral hepatitis (B and C), hemochromatosis (caused by excessive absorption of iron in the intestine), and non-alcoholic fatty liver disease (NASH). The latter condition, also named «soda disease» or «fatty liver», refers to steatosis of the liver. Steatosis constitutes the chronic inflammation of the liver resulting from an accumulation of fat. It is linked to our lifestyle and mostly affects people with diabetes, obesity or high blood pressure.

Liver cancer is often found in cirrhosis

In the majority of cases, people with liver cancer do not have any symptoms, and hepatocellular carcinoma is instead discovered during follow-up of cirrhosis. More rarely, hepatocellular carcinoma is found when there is a decompensation (accumulation of fluid in the peritoneum) of cirrhosis , non-specific symptoms such as weight loss, or abdominal pain caused by rupture and/or bleeding of the tumor.

The diagnosis is based on blood tests and radiological examinations (ultrasound, CT scan and MRI). Depending on the level of risk, the diagnosis can be completed with a biopsy. 

Radiological and surgical treatments for liver cancer

Each case of liver cancer is discussed during a weekly multidisciplinary meeting called tumor board

Treatment for hepatocellular carcinoma depends on the condition of the liver (whether or not cirrhosis is present), the number of tumors, their size(s), and their location(s). The available treatments are surgical and radiological. The different treatment possibilities can be thermal destruction (radiofrequency burning the tumor), occlusion of the vessels that nourish the tumor (embolization), radiotherapy, chemotherapy, surgical removal (hepatectomy) or liver transplantation. Surgery can be performed by laparotomylaparoscopy or robotic surgery. 

Liver metastases

Metastases are tumors that have spread from a primary tumor to other organs.

Due to its role in filtering blood, the liver can receive tumor cells from cancers of the digestive tract. The presence of metastases is usually a sign of cancer at an advanced stage.

Depending on their location, as well as the primary tumor (e.g. colon), metastases may be subject to curative surgical treatment in addition to treatment of the primary tumor. 

Hepatocytes
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The liver´s main cells performing its many functions.
Bile ducts
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Channels through which bile secreted by the liver flows into the small intestine.
Cirrhosis
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Chronic liver disease characterized by the proliferation of scar tissue.
Cirrhosis
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Chronic liver disease characterized by the proliferation of scar tissue.
Tumor board
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A meeting between specialists from several disciplines related to cancer, to determine the best possible treatment for each patient.
INFO +  Tumor Board
Laparotomiy
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open surgery of the abdomen
Laparoscopy
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a surgical technique using small incisions and insertion of a camera
INFO + La chirurgie minimalement invasive par laparoscopie
Last update : 19/07/2021