Das hepatozelluläre Karzinom (HCC) zählt – als die häufigste primäre maligne Tumorerkrankung
der Leber – weltweit zu den tödlichsten Krebsarten. Seine Inzidenz nimmt global zu,
was maßgeblich auf die steigende Prävalenz chronischer Lebererkrankungen zurückzuführen
ist. Während chronische virale Hepatitiden und Alkoholmissbrauch bisher als Hauptrisikofaktoren
galten, gewinnt die Metabolische-Dysfunktions-assoziierte Steatohepatitis (MASH) zunehmend
an Bedeutung.
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and a leading
cause of cancer-related death worldwide. The incidence is increasing globally, primarily
due to the rising prevalence of chronic liver diseases. While chronic viral hepatitis
(HBV, HCV) and alcohol abuse have traditionally been considered the main risk factors,
metabolic dysfunction-associated steatohepatitis (MASH) is increasingly gaining importance,
especially in Western industrialized nations. In the vast majority of cases, HCC develops
on the basis of liver cirrhosis. When cirrhosis is present, diagnosis can usually
be reliably made through dynamic imaging techniques. However, despite established
surveillance programs, most cases of HCC are often diagnosed only at advanced stages,
which significantly limits therapeutic options. The treatment of HCC depends on tumor
stage, overall health, and liver function of the affected patients. Selecting the
appropriate therapy requires a multidisciplinary decision-making process. While curative
options include resection, transplantation, and local ablation, advanced stages are
managed with loco-regional therapies or systemic treatments. In recent years, the
therapeutic spectrum has been significantly expanded by the introduction of immune
checkpoint inhibitors. Particularly, immunotherapeutic combination therapies approved
for first-line treatment have significantly improved the overall survival of patients
with advanced HCC. Nevertheless, the prognosis remains unfavorable in many cases,
highlighting the need for further research to identify predictive biomarkers and develop
innovative therapies.
Schlüsselwörter
Leberkrebs - Leberzirrhose - Surveillance - Immuntherapie
Keywords
Liver cancer - Liver cirrhosis - Surveillance - Immunotherapy
