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Hepatocellular Carcinoma

Home > Patients & Visitors > Diseases & Conditions > Abdominal > Hepatocellular Carcinoma


Hepatocellular Carcinoma (HCC) is a cancer arising from liver cells known as hepatocytes.



In terms of cancer deaths in Singapore, HCC was ranked second amongst men and fifth amongst women during the period of 1998-2002.




Most patients with HCC do not have any symptoms especially in the early stage of the disease. In the later stages, patients may develop jaundice, confusion, bleeding tendencies or fluid in their abdomen known as ascites.



What are the risk factors associated with HCC?

The most common risk factor for HCC in Singapore is being a Hepatitis B virus carrier. Other risk factors include any cause of liver cirrhosis including chronic alcohol dependence, chronic hepatitis C virus infection, autoimmune hepatitis and primary biliary cirrhosis. There is also increasing evidence that obesity and diabetes may be risk factors for cirrhosis. 



Is there a way for earlier detection of HCC in the absence of symptoms?

It is possible to detect HCC early in the absence of symptoms. Patients with risk factors for HCC should undergo screening every six months using ultrasound of the liver and by undergoing a blood test to detect a raised alpha-fetoprotein level.





Diagnosis of HCC can usually be made using a combination of CT and MRI scans. In a small proportion of cases, a liver biopsy may be needed to establish a diagnosis.




Treatment (provided by NUH)

There are now several curative treatment modalities for HCC in selected patients. These include surgery, liver transplantation and radiofrequency ablation (RFA). There are also a host of other treatment modalities used in more advanced stages of HCC including transarterial chemoembolisation (TACE), Yttrium-90 radioembolisation (Y-90) and molecular targeted therapies such as sorafenib.


Surgical Resection 

Surgery is suitable for patients with early stage HCC and well preserved liver function who would tolerate a proportion of their liver being removed. 


Liver Transplantation

Patients transplanted for early to intermediate stage HCC have five year survival rates exceeding 80%. Liver transplantation not only provides a cure for HCC but also for the underlying liver disease.


Radiofrequency Ablation (RFA)

RFA is suitable for patients with small to intermediate size HCCs. A small electrode needle is inserted into the tumour through a small puncture in the skin. An electric current passed through the electrode allows complete ablation of the tumour.



Transarterial Chemoembolisation (TACE)

During TACE, a chemotherapy is injected into the tumour via a blood vessel. Chemotherapy may be coated on to beads.



Yttrium-90 Radioembolisation (Y-90)

Y-90 is a technique whereby radioactive resin beads are deployed into the tumour via a blood vessel. The radioactive beads emit low-energy radioactivity that kills the tumour.



Follow-up after treatment

Patients treated for HCC are followed-up on a regular basis for surveillance of any tumour recurrence.



When to seek medical advice

You should seek medical advice if you have :


1) A family history of liver cancer

2) Liver cirrhosis

3) Chronic hepatitis B

4) Any chronic liver disease (e.g. fatty liver disease, hepatitis C)

5) An elevated alpha-feto protein (tumour marker)



Doctors Listing

Appointment and Enquiry

University Digestive Centre
Kent Ridge Wing 2, Level 4
National University Hospital


Appointment Line:
(65) 6772 2505 or (65) 6773 3380
Fax: (65) 6774 1075
Email: udc@nuhs.edu.sg


Opening Hours:
8.30am - 5.30pm (Mon-Fri)
Closed on Sat, Sun & Public Holiday


NUH Endoscopy Centre
Kent Ridge Wing 2, Level 4
Tel: (65) 6772 4025
Email: endoscopy_centre@nuhs.edu.sg

Opening Hours:
8.30am - 5.30pm (Mon-Fri)
8.30am - 12.30pm (Sat)