Hepatobiliary tumours

Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) are the two major types of primary liver tumour. They are both increasing in incidence in the UK, in the case of HCC because of the increasing prevalence of chronic liver disease, particularly due to alcohol and non-alcoholic fatty liver disease. They have a poor overall prognosis because of late presentation and the presence of underlying liver cirrhosis in patients with HCC. Patients usually present with a liver mass or jaundice. Assessment is primarily radiological by means of CT scan and/or MRI. Surgery remains the major curative option for both tumour types; liver transplantation and, rarely, resection are performed for HCC and surgical resection for CC. However, only approximately 20% of these cancers present at a stage when surgery is possible. For non-surgical candidates with HCC there are three potential treatment options: ablation, transarterial chemoembolization and sorafenib. Chemotherapy for CC is limited to gemcitabine-based systemic chemotherapy. Screening for HCC is a strategy that could potentially enhance early diagnosis.