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Introduction of Liver Cancer:-

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  • Liver cancer is also named as “Hepatic Cancer” or “Hepatocellular Carcinoma”.

  • Liver cancer is cancer that begins in the tissues of liver.

  • Liver cancers are malignant tumors that grow on the surface or inside the liver.

  • Liver cancer is the third most common cancer in the world, and the majority of patients with liver cancer will die within one year as a result of the cancer. But liver cancer is uncommon in the United States.

  • Cancer that begins in another area of the body, such as the colon, liver or breast, and then spreads to the liver is called “metastatic cancer”, rather than liver cancer.

  • The natural history of liver cancer is variable and it depends upon the stage of the tumor and the severity of the associated cirrhosis.

 

Types of Liver Cancer: – There are several types of liver cancer based on the type of cells that becomes cancerous. Liver Cancer mainly is of two types:

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  • Primary Liver Cancer.

  • Secondary Liver Cancer.

 

Primary Liver Cancer:

 

Hepatocellular carcinoma (HCC):- It is also called as “Hepatoma”. It is the most common type of liver cancer. It mostly accounts for approximately 75 percent of all liver cancers. It starts in the main type of liver cells called as “Hepatocellular cells”. Most cases of HCC are due to infection with hepatitis B or C and cirrhosis of the liver caused by alcoholism. It is much more likely to develop in men than in women. It also becomes more common as people get older.

Fibrolamellar HCC: – It is a rare subtype of HCC. “Fibro” means to fibrous tissue and “lamellar” means the plate like structure of the cells. Fibrolamellar carcinoma tends to develop in younger people who do not havecirrhosis or infection with hepatitis B or C. Usually Fibrolamellar HCC has better prognosis than HCC.

Cholangiocarcinoma: – It is cancer of bile duct. It occurs in the small, tube-like bile ducts within the liver that carry bile to the gallbladder. Cholangiocarcinomas accounts for 10-20 percent of all liver cancers. Cholangiocarcinomas are of two types:-

Intrahepatic bile duct cancer: – It begins in ducts within the liver.

Extrahepatic bile duct cancer: – It develops in ducts outside of the liver.

Angiosarcoma: –This type of liver cancer is also called “Hemangiocarcinoma”. This type of cancer accounts for about 1 percent of all liver cancers. Angiosarcomas begin in the blood vessels of the liver and grow quickly. They are typically diagnosed at an advanced stage. It is most commonly seen in people with age group of 70 years to 80 years of age group.

 

Secondary liver cancer

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It is also known as a “liver metastasis”. It develops when primary cancer from another part of the body spreads to the liver. Most liver metastases originate from colon or colorectal cancer. More than half of people diagnosed with colorectal cancer develop secondary liver cancer.

 

Basic Pathology of Liver Cancer:-

 

Staging and grading of Liver Cancer is totally depends upon TNM classification based on “The American Joint Committee on Cancer” (AJCC). It depends upon three primary factors.

Tumor (T):-Itdescribes the number and size of the original tumor.

Lymph Node (N):- It indicates whether the cancer is present in the regional lymph nodes.

Metastasis (M):- Itrefers to whether cancer has spread to distant parts of the body.

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Liver cancer stages are as follows:

 

Stage 1: – It is single primary tumor of any size. Itis found only in liver and not grown into any blood vessels. The cancer has not spread to nearby lymph nodes or distant sites also.

Stage 2:- It is also single primary tumor of any size OR there is more than one tumor present in liver. But in this stage 2, tumor has spread to the blood vessels, and they are all smaller than 5 cm in diameter. The cancer has not spread to nearby lymph nodes or distant sites also.

Stage 3:- Stage 3 liver cancer is divided into three subcategories:

Stage 3(A):- In this stage, there are several tumors and one of them is larger than 2 inches (5 cm) in diameter. The cancer has not spread to nearby lymph nodes or distant sites.

Stage 3(B):- In this stage, there are several tumors and one tumor of them is growing into a branch of the portal vein or the hepatic vein. The liver cancer has not spread to nearby lymph nodes or distant sites

Stage 3(C):- In this stage, the tumor has grown into a nearby organ (other than the gallbladder) OR the tumor has grown into the outer covering of the liver. The cancer has not spread to nearby lymph nodes or distant sites.

Stage 4:- Stage 4 liver cancer is divided into two subcategories:

Stage 4(A):- In this stage, the tumors is of any size or number and have spread beyond the liver to blood vessels or nearby organs. The cancer has invaded nearby lymph nodes, but cancer has not spread to distant sites.

Stage 4(B):- In this stage, liver cancer has spread to other parts of the body (Metastasis).

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