Liver cancer is a major cause of death in many countries (especially in Asia), and the number of people diagnosed is expected to increase, according to the IARC. 1.3 million people could die from it by 2040.
cancer of the foie is a leading cause of death in many countriesand the number of people diagnosed with liver cancer is expected to increase. These are the conclusions of a study conducted by doctors from IARC (International Agency for Research on Cancer which depends on the WHO) published in October 2022. The number of new cases of liver cancer per year expected to increase by 55% between 2020 and 2040, with 1.4 million patients worldwide in 2040 and 1.3 million deaths. L’incidence of liver cancer is higher in menin Asia (especially China) and North Africa. In Francethe estimated number of new cases of liver cancer according to the‘Inca is of 10,580, of which 77% in men. Liver cancer is 13% of digestive cancersand he is the second most common cancer in men and the third cancer most frequently in the woman among them. With 8,697 deaths estimated in 2018 of which 72% in menliver cancer is the fourth most common cancer death in men and the seventh in women’s.
Definition: what is liver cancer?
The liver is an organ of the digestive system which notably ensures cleansing role in the body. It is necessary to distinguish the primary liver tumors which develop in this organ of the tumors secondary to another cancer (breast, lung, kidney…) also called “metastases liver”. The two types of liver cancer are:
- the hepatocellular carcinoma (hepatocarcinoma) which develops from hepatocytes, the majority cells of the liver (85% of liver cancer cases)
- intrahepatic cholangiocarcinoma (from bile duct cells)
- l’angiosarcome
- hepatoblastoma (in children)
This cancer occurs more in men (80%) than in women (20%) and more often following a liver disease (chronic hepatitis, cirrhosis) than on a healthy liver. When it comes to metastases from other cancers, which is common because the liver is a richly vascularized organ, one or more nodules can be observed.
At what age does liver cancer occur?
The median ages at diagnosis are 69 years for men and 73 years for women. Trends by age show a increased incidence which mainly affects men from the age of 50 with a maximum average annual increase of +2.7% at age 80.
What are the symptoms of liver cancer?
Several symptoms, often mild and occurring during many pathologies, can lead to the discovery of liver cancer. Let us mention in particular:
- of the abdominal pain,
- a fever,
- fatigue with loss of appetite and weight
- the appearance of jaundice
- nausea, vomiting
- swollen abdomen
First, liver tumors often remain silent. This asymptomatic phase delays the diagnosis and can therefore lead to a less favorable prognosis. Of the regular ultrasounds are recommended for people with known liver disease (cirrhosis) whatever the cause (excessive alcohol consumption, chronic infection with viral hepatitis B or C).
The main risk factor for liver cancer remains chronic alcoholism.
What are the causes of liver cancer?
cirrhosis is the main cause of liver cancer. The alcohol is the primary cause of cirrhosis. liver infection, Hepatitis B and hepatitis C can be complicated by cirrhosis and therefore secondarily by liver cancer. Regarding secondary cancers, or metastasis, many primary cancers can “metastasize” to the liver, such as lung, colon or breast cancer.
What are the risk factors for liver cancer?
- chronic alcohol consumption (risk of cirrhosis)
- hepatitis B and C virus (risk of cirrhosis)
- the surcharge in fer (hemochromatosis),
- obesity,
- diabetes,
- chronic smoking,
- hepatic steatitis,
- the male gender
- age over 50 are other risk factors.
In people with chronic liver disease, the practice of a ultrasound hepatic and a regular blood test for alpha-fetoprotein (AFP)liver tumor marker are required. The scanner or MRI are the main diagnostic tests. L’AFP (alpha-fetoprotein) is a tumor marker of the liver, that is to say a molecule present in the blood and whose dosage allows screening for cancer and monitoring the effectiveness of treatment. The blood level of AFP can be increased in the event of liver cancer, but this is not systematic. AFP is also increased in other diseases such as, for example, during viral hepatitis or cancers of the digestive system. An extension assessment is carried out in order to search for metastases. A brain scan, a chest x-ray and a bone scan may be requested.
What are the complications of liver cancer?
Complications depend on the stage at which liver cancer is discovered. The main complication of liver cancer is liver failure, itself causing many symptoms and digestive disorders, often accompanied by an alteration of the general state. The prognosis of liver cancer is unfavorable and death unfortunately occurs frequently.
What are the treatments for liver cancer?
The prognosis of liver cancer varies according to several parameters: primary cancer or not, extension of the tumor, size of the tumor, number of tumors, general condition of the patient, presence of metastases… Thus, the use of surgery is mainly indicated when tumor ablation is possible. For this, it is necessary that the tumor is localized and unique. In case of metastatic cancer, the choice of chemotherapy Adjuvant therapy is generally essential to prepare for a possible surgical intervention by reducing the number and size of metastases. Liver transplantation represents the treatment of primary liver cancer in certain very specific cases. It can only be offered for small tumors. The results are very satisfactory: the recurrence rate at 5 years is around 15%. The waiting times are very long. When there are contraindications to surgery or liver transplantation, alternative treatments may be offered. Alcoholization, or the destruction by radio frequencyare more recent techniques allowing destruction of the tumour. Chemotherapy by embolization is performed by introducing a drug into the arteries of the liver while removing the blood supply to the tumor. When the liver transplant is impossible, surgery may be considered. The intervention consisting of partial removal of the liver. The operation will seek to preserve as much healthy tissue as possible. Monitoring the blood level of the alpha feto protein, AFP, after the surgical intervention makes it possible to check the risk of recurrence.
Liver cancer is a disease poor prognosis.
What is the prognosis for liver cancer?
Liver cancer is a disease poor prognosis. The median ages at death are 71 years for men and 78 years for women. The liver is a vital organ, highly vascularized, which induces a high risk of metastases. In addition, liver cancer is generally asymptomatic, which, apart from regular monitoring for another pathology (cirrhosis), leads to a risk of late diagnosis. These elements explain why the chances of survival are relatively low (about 13% at 5 years). However, many factors can cause this figure to vary (general state of health, age, location, etc.).
Sources: Inca / ARC Foundation / Bordeaux University Hospital.