Every October, and especially on October 30, medical and patient associations launch awareness campaigns about liver cancer. Their goal is to highlight the importance of early diagnosis and prevention, promote hepatitis B vaccination, hepatitis C treatment, and the control of fatty liver disease and alcohol consumption.
At IVOQA, we join this commitment by promoting medical check-ups, screening programs for high-risk patients, and access to the most innovative treatments. Our Tumor Board includes specialists in both primary and metastatic liver cancer, as well as surgeons specialized in minimally invasive liver surgery and interventional radiologists highly experienced in liver tumor and metastasis ablation.
Liver cancer remains one of the leading causes of cancer-related mortality worldwide. Its management requires a multidisciplinary and updated approach that integrates prevention, early detection, and the latest therapeutic innovations.
What Is Liver Cancer?
The term refers to the uncontrolled growth of malignant cells within the liver. It is important to distinguish between primary liver cancer and liver metastases.
Types:
- Primary liver cancer: when the tumor originates within the liver itself. The most common forms are:
- Hepatocellular carcinoma (HCC): accounts for 80–90% of cases, usually developing in livers affected by cirrhosis or chronic hepatitis.
- Intrahepatic cholangiocarcinoma: a less common cancer that arises from the bile ducts inside the liver.
- Liver metastases: tumors that spread to the liver from other organs (colon, breast, lung, among others). Their treatment depends on the primary tumor type.
Common Risk Factors
Liver cancer often develops in a previously diseased liver. The main risk factors include:
- Chronic hepatitis B and C infections, still responsible for a large proportion of global cases.
- Cirrhosis from any cause.
- Excessive alcohol consumption.
- Non-alcoholic fatty liver disease (NAFLD/NASH): increasingly common due to the obesity and metabolic syndrome epidemic.
Preventing and managing these conditions is essential to reduce liver cancer incidence.
Life Expectancy in Liver Cancer Patients
Survival depends on several factors, including tumor stage at diagnosis, liver function, and the treatment received.
For patients with hepatocellular carcinoma (HCC):
- Early diagnosis: when the tumor is small and liver function is preserved, curative options (surgery, transplantation, ablation) can achieve 5-year survival rates of 50–70% in selected patients.
- Advanced disease: prognosis is more limited, although in recent years, systemic therapies have significantly improved median survival.
According to the treatment received:
- Surgery (including minimally invasive laparoscopic and robotic liver surgery) and liver transplantation offer the best chances of cure when feasible. Transplantation is now indicated not only for primary liver tumors but also for colon cancer liver metastases in selected cases.
- Locoregional therapies: such as radiofrequency ablation (RFA). In 2025, a landmark clinical trial reported that ablation for liver metastases from colon cancer achieves equivalent oncological outcomes to surgery, offering a minimally invasive alternative for eligible patients. Other treatments include chemoembolization, used when surgery is not possible, to reduce tumor size and number.
- New systemic therapies: combinations of immunotherapy and targeted drugs have transformed advanced disease management.
The integration of all these therapeutic approaches has marked a paradigm shift, improving both survival and quality of life in advanced-stage patients.
For patients with liver metastases from colon cancer:
Without treatment:
- Median survival: 5–20 months
- 5-year survival: Extremely rare
With treatment:
Surgery (resection or ablation): offers the best chance of cure.
- 5-year survival: 24–58%
Systemic chemotherapy without surgery:
- 5-year survival: Below 10%
Advances in Liver Cancer Research
Recent years have brought significant advances in clinical research, especially for hepatocellular carcinoma (HCC).
Immunotherapy has been a major breakthrough. Combinations such as atezolizumab + bevacizumab (IMbrave150 trial) and tremelimumab + durvalumab (HIMALAYA trialv) have shown significant overall survival benefits compared to standard treatments like sorafenib.
More recently, the LEAP-012 trial represented the first major advance in 20 years for patients with intermediate-stage HCC. The combination of lenvatinib + pembrolizumab + chemoembolization achieved a progression-free survival of 14.6 months, compared to 10 months with standard treatment, and an overall response rate of 72%. This study marks a new paradigm in managing these patients.
Furthermore, at the Liver Cancer Summit 2025, the EASL presented new European guidelines incorporating multiparametric decision models, LI-RADS criteria, and combined therapeutic strategies, strengthening the personalized and multidisciplinary approach to HCC management.
