Hepatocellular carcinoma — master index

Last curated: 2026-08-30 · status: audited

Build at a glance: 17 curated wiki pages · 3,978 wiki lines · 328 bibliography papers (325 referenced by wiki pages plus 3 registry-only superseded ESMO/EASL records) · 39 live-verified NCT identifiers · 5 landmark paper notes · 26 open questions and 15 cross-domain junctions · 122 statistics-table rows · global/regional guideline registry with explicit supersession chains · 4 patient-voice files.

The condition in five sentences. Hepatocellular carcinoma (HCC) constitutes the great majority of primary liver cancer, while liver cancer caused 7.8% of global cancer deaths in 2022 (McGlynn 2021, PMID 32319693; Bray 2024, PMID 38572751). Its epidemiology is moving from predominantly HBV/HCV-associated disease toward alcohol-associated and metabolic liver disease, yet viral hepatitis remains globally important and offers the strongest prevention levers through vaccination and antiviral treatment (Singal 2023, PMID 37884736). HCC is a dual cancer-and-organ-failure problem: tumor burden, liver reserve, portal hypertension, performance status, and transplant access jointly determine treatment, formalized most widely in BCLC 2022 (Reig 2022, PMID 34801630). Six-month surveillance is standard for sufficiently high-risk, treatment-eligible patients, but the only large positive randomized trial was in chronic HBV and ultrasound alone detects only about 47% of early HCC in meta-analysis (Zhang 2004, PMID 15042359; Tzartzeva 2018, PMID 29425931). Systemic therapy is now immunotherapy-combination based, while recurrence after local cure, non-cirrhotic MASLD surveillance, transplant selection, Child-Pugh B treatment, and post-IO sequencing remain major unresolved problems (Finn 2020, PMID 32402160; Mazzaferro 2018, PMID 28989060).

Start here: overview. The research frontier is OPEN-QUESTIONS.md. Build history is LOG.md.

Reading paths

New to HCC

1. Overview
2. Epidemiology and etiology
3. Cirrhosis and risk stratification
4. Surveillance and early detection
5. Diagnosis and imaging
6. Staging and treatment allocation

Curative and transplant pathway

1. Diagnosis and imaging
2. Surgical resection and ablation
3. Liver transplantation
4. Locoregional therapy
5. Biomarkers

Advanced/intermediate disease

1. Staging and treatment allocation
2. Locoregional therapy
3. Systemic therapy
4. Molecular landscape
5. Clinical trials landscape
6. Red flags and safety concerns

MASLD transition and early detection

1. MASH/MASLD and HCC
2. Epidemiology and etiology
3. Cirrhosis and risk stratification
4. Surveillance and early detection
5. Biomarkers

Patient, caregiver, and safety lens

1. Patient experience and advocacy
2. Red flags and safety concerns
3. Guidelines
4. Patient-voice layer

Pages (canonical list)

File	Scope	Status
overview.md	What HCC is, why it matters, map of the topic	curated
epidemiology-and-etiology.md	Global burden, geographic patterns, viral-to-metabolic transition, prevention	curated
cirrhosis-and-risk-stratification.md	Cirrhotic substrate, etiology-specific incidence, risk scores, surveillance eligibility	curated
surveillance-and-early-detection.md	Ultrasound/AFP evidence and harms, underuse, abbreviated MRI, blood panels	curated
diagnosis-and-imaging.md	Non-invasive diagnosis, LI-RADS, CT/MRI/CEUS, biopsy, response imaging	curated
staging-and-treatment-allocation.md	BCLC 2022, alternatives, stage migration, multidisciplinary allocation	curated
molecular-landscape.md	Drivers, mutational signatures, immune classes, single-cell biology	curated
surgical-resection-and-ablation.md	Resection selection, ablation, recurrence, adjuvant question	curated
liver-transplantation.md	Milan/expansions, downstaging, recurrence, organ-allocation ethics	curated
locoregional-therapy.md	TACE, TARE/dosimetry, radiation, systemic combinations	curated
systemic-therapy.md	TKI-to-IO genealogy, first line, later lines, sequencing and safety	curated
mash-masld-hcc.md	Non-cirrhotic HCC, surveillance gap, metabolic biology, IO controversy	curated
biomarkers.md	AFP, GALAD, liquid biopsy, prognosis and treatment selection	curated
guidelines.md	AASLD/EASL/ESMO/APASL/Asian synthesis and disagreements	curated
clinical-trials-landscape.md	Completed genealogy and live active-trial portfolio	curated
patient-experience-and-advocacy.md	Symptoms, decisions, stigma, caregivers, transplant journey, organizations	curated
red-flags-and-safety-concerns.md	Decompensation, bleeding, IO/VEGF/procedural hazards, surveillance lapses	curated

All 17 pages passed the separate-session citation audit on 2026-08-30 and are curated.

Literature layer

Artifact	Contents	Status
BIBLIOGRAPHY.md	328 unique PMID-indexed papers (325 wiki-referenced plus 3 registry-only superseded records), one line each with cited-by mapping	audited
notes/	Five deep notes: Milan, SHARP, exome landscape, IMbrave150, BCLC 2022	audited
guidelines/REGISTRY.md	AASLD, EASL, ESMO, BCLC, APASL full/systemic, JSH, KLCA-NCC components, China 2024, OPTN; supersession/gaps/watch list	audited
statistics/STATISTICS.md	122 table rows spanning burden, risk, surveillance, diagnosis, biomarkers, treatment, transplant, safety, disparities, and preferences	audited
patient-voice/README.md	Method, ethics, organizations, themes, annotated sources	audited

Curation state

Full build completed 2026-08-28 and was deepened and independently audited page by page on 2026-08-30 using live PubMed E-utilities and ClinicalTrials.gov API v2 retrieval. All 17 pages passed identifier resolution, author/year/journal matching, claim/abstract and number checks, reference completeness, link/structure checks, and current-trial-status validation; all are curated.