ABSTRACT
In many parts of the world, particularly sub-Saharan Africa and the Far East, hepatocellular carcinoma (HCC) is a major public health problem. Although progress towards effective therapy has been slow, low-cost vaccines against the hepatitis B virus and anti-viral treatment may now be starting to reduce the incidence of this malignancy. Worldwide, the liver is the most common, and often the clinically predominant, site of metastatic cancer. After considering briefly the aetiological factors and the clinicopathological features of HCC, this chapter goes on to describe the possible modes of therapy. These have been grouped broadly into surgery, locoregional treatments and cytotoxic, and other systemic, chemotherapy. Hepatocellular carcinoma will be considered first, then selected aspects of metastatic liver disease. Since management of hepatic metastases from primary carcinoid tumours may pose additional problems, because of the associated carcinoid syndrome, the possible therapeutic approaches are discussed separately.
