Liver resection for hepatocellular and fibrolamellar carcinoma in a South African tertiary referral centre
type: CreativeWork
description: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy in adults and is the fifth most common solid tumour worldwide with a variable prevalence based on underlying risk factors and geography. The incidence has risen over the past several decades and HCC is now the third leading cause of cancer-related deaths globally, after lung and stomach cancers, with a 5-year survival rate less than 20% and recurrence rates as high as 88%. More than 80% of global HCCs occur in sub-Saharan Africa (SSA) and Eastern Asia where the incidence ranges from 4.8 to 8.3 per 100,000 per year in different regions of SSA with the highest incidence in the western central Africa compared to less than 3 per 100 000 in Western countries. Hepatocellular carcinoma has become a significant public health concern in SSA and is now the second leading cancer in men and the third for women, occurring in particular in young adults. Unfortunately only a small proportion of patients in SSA with HCC are treated with curative intent. Data are scarce, but studies consistently report that curative-intended treatment is pursued in less than 1% of patients in SSA with HCC. Fibrolamellar carcinoma (FLC) was until recently regarded as a variant of HCC occurring in young patients with a relatively good prognosis but is now recognized as a distinct clinical entity with consistent chimeric fusion protein (DNAJB1-PRKACA) expression by FLC tumours. The optimal treatment of HCC and FLC is influenced by the stage of the disease, the degree of liver impairment, and patient performance status. Currently, the therapeutic strategy is based on international guidelines and the Barcelona Clinic Liver Cancer (BCLC) staging system in which potentially curative treatment for early-stage HCC includes resection, transplantation and ablation. Surgical resection is the treatment of choice in patients without cirrhosis and in those with cirrhosis and well-preserved hepatic function. Despite advances in surgical tech…
abstract: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy in adults and is the fifth most common solid tumour worldwide with a variable prevalence based on underlying risk factors and geography. The incidence has risen over the past several decades and HCC is now the third leading cause of cancer-related deaths globally, after lung and stomach cancers, with a 5-year survival rate less than 20% and recurrence rates as high as 88%. More than 80% of global HCCs occur in sub-Saharan Africa (SSA) and Eastern Asia where the incidence ranges from 4.8 to 8.3 per 100,000 per year in different regions of SSA with the highest incidence in the western central Africa compared to less than 3 per 100 000 in Western countries. Hepatocellular carcinoma has become a significant public health concern in SSA and is now the second leading cancer in men and the third for women, occurring in particular in young adults. Unfortunately only a small proportion of patients in SSA with HCC are treated with curative intent. Data are scarce, but studies consistently report that curative-intended treatment is pursued in less than 1% of patients in SSA with HCC. Fibrolamellar carcinoma (FLC) was until recently regarded as a variant of HCC occurring in young patients with a relatively good prognosis but is now recognized as a distinct clinical entity with consistent chimeric fusion protein (DNAJB1-PRKACA) expression by FLC tumours. The optimal treatment of HCC and FLC is influenced by the stage of the disease, the degree of liver impairment, and patient performance status. Currently, the therapeutic strategy is based on international guidelines and the Barcelona Clinic Liver Cancer (BCLC) staging system in which potentially curative treatment for early-stage HCC includes resection, transplantation and ablation. Surgical resection is the treatment of choice in patients without cirrhosis and in those with cirrhosis and well-preserved hepatic function. Despite advances in surgical tech…
author: Ziaei, Yalda
language: en
keywords: Hepatocellular carcinoma (HCC)
date published: 2025
date modified: 2026-07-22T22:22:58Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Division of General Surgery

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/41977