Hepatobiliary tumours

Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two major types of primary liver tumour. Both are increasing in incidence in the UK, for HCC because of the increasing prevalence of chronic liver disease, particularly that caused by 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 computed tomography and/or magnetic resonance imaging. Surgery remains the major curative option for both tumour types; liver transplantation and, rarely, resection are performed for HCC, and surgical resection for cholangiocarcinoma. 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 types: ablation, trans-arterial chemo-embolization or an increasing range of new systemic treatments. Chemotherapy for cholangiocarcinoma is limited to gemcitabine-based systemic chemotherapy. Surveillance for HCC could potentially enhance early diagnosis.