Reuters Health Information (2004-11-01): Liver cancer fastest growing malignancy in US: Liver Cancer Network
Liver cancer fastest growing malignancy in US: Liver Cancer Network
Last Updated: 2004-11-01 15:41:11 -0400 (Reuters Health)
BOSTON (Reuters Health) - A preliminary report from the
Liver Cancer Network shows that hepatocellular carcinoma (HCC) is the
fastest growing cancer in the US and hepatitis C infection is involved
in more than half of cases, investigators told attendees here Monday at
the 55th annual meeting of the American Association for the Study of
In presenting the early data, lead investigator Dr. Alex S. Befeler
of St. Louis University, Missouri, noted that the Network was
established because of a dearth of information about the epidemiology
of liver cancer and also to better analyze the numerous and often
competing HCC staging systems.
The Network has currently enrolled approximately 250 patients to
date from 6 centers. Serum has been collected and demographics, risk
factors for HCC, liver disease, tumor characteristics and treatment
The mean HCC patient age was 59 years old, 75% are male, 80%
Caucasian, 10% African American, 4% Hispanic and 4% East Asian. The
mean follow-up was approximately 6 months.
Most HCC patients (87%) had underlying liver disease and more than
half (52%) of those enrolled had hepatitis C infection. A history of
alcohol abuse was involved in 20% of those cases, with a history of
alcohol abuse present in 12% of the group overall. Eleven percent had
hepatitis B infection and 2% had hemochromatosis.
Dr. Befeler reported that 42% were asymptomatic on presentation.
Among the treatments given were radiofrequency ablation (13%), surgical
resection (12%), transplantation (9%), experimental protocols (4%) and
systemic chemotherapy (6%). Forty percent received no treatment.
"HCC in the US is almost always associated with chronic liver
disease," the Network data show. Survival is "significantly better for
those who were asymptomatic at presentation or who were candidates for
liver transplantation," Dr. Befeler said. He added that a major problem
has been that "oncologists and tumor registries have poor staging
systems," which is further confounded by frequent competition and
conflict between the systems.
"The UNOS organ allocation system is best," Dr. Befeler told Reuters
Health. The Tumor Node Metastasis (TMN) system, which classifies
patients according to tumor size, "doesn't work very well," he noted,
nor does the Barcelona Clinic Staging System or Japan's Okuda system --
the original staging system for HCC.
The bottom line, and the primary reason for the Liver Cancer
Network, is that "chemotherapy is generally ineffective for liver
cancer. Liver transplantation is the best approach...Most patients also
have advanced cirrhosis, so drug metabolism is poor," Dr. Befeler added.