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Liver cancer, or hepatic cancer, may be primary, where it originates in the liver, or secondary, where cancer has spread, or metastasized, to the liver from other parts of the body. In the case of secondary tumors, the behavior and outlook will vary according to the origin of the cancer. For primary liver cancers, the outlook is often poor because the disease does not cause noticeable symptoms until it has reached an advanced stage. The more a cancer has progressed by the time it is discovered, the worse the prognosis. A prognosis for liver cancer is also affected by a person's general health and the health of the liver, the types of treatments which are undergone and whether the person takes part in any clinical trials.
The most common form of liver cancer is known as hepatocellular carcinoma, or hepatoma. Cancer risk is increased in people who have cirrhosis of the liver, where the liver tissue is scarred, due to alcoholism or an infection such as hepatitis C. Hepatitis B infections which persist for a long time can also increase the risk of liver cancer developing. Symptoms can be vague initially, or may be disguised by the symptoms of cirrhosis, but could include pain, an abdominal mass or swelling and jaundice. Tests are normally carried out to confirm that cancer is present, to determine the stage of progression and to assess the function of the liver.
Staging is important in the individual's prognosis for liver cancer. There are four possible stages for liver cancer. Stage one carries the best prognosis and is used to describe a small tumor which has not spread beyond the liver or invaded nearby blood or lymph vessels. In stage four, which is associated with the worst prognosis for liver cancer, the cancer has spread beyond the liver, and secondary tumors, known as metastases, are present in other parts of the body.
If liver cancer is discovered at an early stage, surgery may be carried out. A liver transplant operation carries the best prognosis for liver cancer, with around 80 percent of people living for four years following surgery. Sometimes surgery is used to remove cancer from the liver, and this has a slightly less positive outlook, with only about 15 percent of people surviving for five years. If the tumor that is removed is very small, the outlook improves, with over half of patients expected to be alive five years later.
For healthy people, the prognosis for liver cancer is better because general fitness gives a person the ability to withstand more treatments. An unhealthy, cirrhosed liver gives a worse prognosis as it will be less likely to recover from surgery. Taking part in clinical trials is known to be associated with a more positive outlook but it is not known exactly why this occurs.