Comprehensive care for patients with hepatocellular carcinoma: insights from the 2022 San Antonio Liver Cancer Symposium

After decades of an increase in patients diagnosed with hepatocellular carcinoma (HCC) in the U.S., rates of liver cancer have stabilized in men but continue to rise in women by about 2% per year (1). Further, many patients with HCC have the underlying comorbidity of cirrhosis, the ninth leading cause of death (1), which is incurable without a liver transplant. Although 5-year survival for HCC has increased over the last few decades, less than 1 in 4 patients (22%) survive beyond 5 years (1).

Unfortunately, most patients diagnosed with HCC present with advanced disease that is not amenable to curative therapy (2). Therefore, comprehensive care for HCC should include early involvement of palliative care services (2,3). While advanced HCC is incurable with current therapies, treatments such as immunotherapy and radiation therapy, can alleviate symptoms and improve quality of life (2,3). Therefore, we wanted to create a series based on the insights from the 2022 San Antonio Liver Cancer Symposium, which brought further awareness to the multitude and breadth of palliative therapies available for patients with HCC as well as cirrhosis.

Topics for this special series include management of cirrhosis during the treatment of HCC, transplantation and HCC, treatment of localized HCC and multifocal HCC, rehabilitation in patients with HCC, novel therapeutics in advanced HCC, multi-disciplinary care for patients with HCC, management of autoimmune and viral hepatitis in the setting of immunotherapy, hepatorenal syndrome and HCC, sarcopenia in HCC, and supportive and end of life care considerations in advanced HCC.

We hope this special series will provide insights into the complexity of supportive care services and palliative therapeutics for patients with HCC. This series will continue to promote the vision of the San Antonio Liver Cancer Symposium by fostering dialogues at academic conferences and inspiring future clinical and research programs in palliative care for HCC.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Annals of Palliative Medicine for the series “Comprehensive Care for Patients with Hepatocellular Carcinoma: Insights from the 2022 San Antonio Liver Cancer Symposium”. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://apm.amegroups.com/article/view/10.21037/apm-24-36/coif). The series “Comprehensive care for patients with Hepatocellular Carcinoma: Insights from the 2022 San Antonio Liver Cancer Symposium” was commissioned by the editorial office without any sponsorship or funding. S.P.A. and S.R.C. served as unpaid Guest Editors for the series. S.P.A. also serves as an unpaid editorial board member of Annals of Palliative Medicine from June 2022 to May 2024. S.P.A. reports that she serves on the advisory board and receives personal fees from AstraZeneca, QED Therapeutics, and Seagen, and she also receives personal fees for speaker bureau from Exelixis, Bayer, and Bristol Meyers Squibb, outside the submitted work. S.R.C. is a faculty member at UT Health San Antonio, uncompensated and voluntary participation, and meets quarterly to review institutional studies for safety. The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

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3. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol 2022;76:681-93. [Crossref] [PubMed]

Sukeshi Patel Arora

Sherri Rauenzahn Cervantez