The development of hepatocellular carcinoma is generally preceded by chronic liver damage leading to cirrhosis. Prevention of chronic liver diseases can decrease the incidence of hepatic cancer impressively. Many recent investigations have also explored the power of secondary and tertiary prevention in established liver cirrhosis. Screening programs for patients at high risk, antiviral treatment of patients with progressed hepatitis, and adjuvant interventions after curative resection are some of the approaches. However, the cost effectiveness and benefits of such procedures and the prognosis is also dependent on the remaining liver function, there is no consensus to date on how patients should be handled. In the future molecular markers and prognostic scores may help better define the group at risk of developing. To give a perspective to these patients, it is necessary to improve the treatment of hepatocellular carcinoma as well as cirrhosis.
Copyright 2002 S. Karger AG, Basel