Hepatocellular carcinoma — master index¶
Last curated: 2026-10-25 · status: audited 2026-08-30; subsequent sweep changes pending independent audit
Build at a glance: 17 wiki pages (6 curated, 11 draft) · 4,073 wiki lines · 376 bibliography papers · 51 NCT identifiers live-checked across the condition on 2026-10-25 · 5 landmark paper notes · 26 open questions and 9 cross-domain junctions · 147 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¶
- Overview
- Epidemiology and etiology
- Cirrhosis and risk stratification
- Surveillance and early detection
- Diagnosis and imaging
- Staging and treatment allocation
Curative and transplant pathway¶
- Diagnosis and imaging
- Surgical resection and ablation
- Liver transplantation
- Locoregional therapy
- Biomarkers
Advanced/intermediate disease¶
- Staging and treatment allocation
- Locoregional therapy
- Systemic therapy
- Molecular landscape
- Clinical trials landscape
- Red flags and safety concerns
MASLD transition and early detection¶
- MASH/MASLD and HCC
- Epidemiology and etiology
- Cirrhosis and risk stratification
- Surveillance and early detection
- Biomarkers
Patient, caregiver, and safety lens¶
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 | draft |
| 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 | draft |
| 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 | draft |
| surgical-resection-and-ablation.md | Resection selection, ablation, recurrence, adjuvant question | draft |
| liver-transplantation.md | Milan/expansions, downstaging, recurrence, organ-allocation ethics | draft |
| locoregional-therapy.md | TACE, TARE/dosimetry, radiation, systemic combinations | draft |
| systemic-therapy.md | TKI-to-IO genealogy, first line, later lines, sequencing and safety | draft |
| mash-masld-hcc.md | Non-cirrhotic HCC, surveillance gap, metabolic biology, IO controversy | draft |
| biomarkers.md | AFP, GALAD, liquid biopsy, prognosis and treatment selection | draft |
| guidelines.md | AASLD/EASL/ESMO/APASL/Asian synthesis and disagreements | draft |
| clinical-trials-landscape.md | Completed genealogy and live active-trial portfolio | draft |
| 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. The 2026-10-11, 2026-10-18 and 2026-10-25 sweeps left 11 pages as draft until a different engine audits them; see LOG.md.
Literature layer¶
| Artifact | Contents | Status |
|---|---|---|
| BIBLIOGRAPHY.md | 376 unique PMID-indexed papers; 4 added 2026-10-25, including CARES-009 as a historical recovery | Sweep additions pending audit |
| notes/ | Five deep notes: Milan, SHARP, exome landscape, IMbrave150, BCLC 2022 | audited |
| guidelines/REGISTRY.md | AASLD, EASL, ESMO (+ Pan-Asian 2026), BCLC, APASL full/systemic, JSH, KLCA-NCC components + SBRT 2026, China 2024, OPTN, AGA 2026, ACG 2026, MSGH 2026, Brazil 2026, HCC-Live trial-design consensus, NCCN v2.2026, IHPBA 2026, AASLD Critical Update, BEACON-HCC, JSH Japanese 2025 listing, and China 2026 conversion-surgery consensus; supersession/gaps/watch list | Sweep additions pending audit |
| statistics/STATISTICS.md | 147 table rows spanning burden, risk, surveillance, diagnosis, biomarkers, treatment, transplant, safety, disparities, and preferences (9 added 2026-10-25) | Sweep additions pending audit |
| patient-voice/README.md | Method, ethics, organizations, themes, annotated sources; public resources refreshed 2026-10-25 | refresh pending audit |
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; subsequent sweeps have re-drafted edited pages for independent review.