Department of Gastroenterology, Alfred Hospital, Melbourne, Victoria, Australia.
Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Intern Med J. 2021 Feb;51(2):181-188. doi: 10.1111/imj.15184.
Hepatocellular carcinoma (HCC) is the commonest primary liver cancer encountered in the community and a leading cause of cancer morbidity and mortality. In Australia, there are several current important issues that need to be addressed in HCC management. There is a dramatically rising incidence of HCC in Australia with comparatively poorer outcomes in remote regions and in socioeconomic disadvantaged groups. Aboriginal people have a greater incidence of HCC on a background of increased liver disease prevalence and face several barriers to delivery of better healthcare outcomes compared to other Australians. The previously adopted use of imaging alone to diagnose HCC is now being challenged with biopsy likely to become increasingly necessary with the increased uptake of personalised medicine management. Managing HCC is complex involving many disciplines with the multidisciplinary team approach being the current accepted standard of care for patients. New immunotherapy combinations promise to offer patients with advanced HCC promising novel management options. However, the Australian inequities in prevalence, diagnosis and service provision, especially in Aboriginal people, need to be redressed concurrently with the adoption of new HCC management options.
肝细胞癌（HCC）是在社区中最常见的原发性肝癌，也是癌症发病率和死亡率的主要原因。在澳大利亚，HCC 管理中存在几个当前需要解决的重要问题。澳大利亚 HCC 的发病率急剧上升，在偏远地区和社会经济弱势群体中的预后较差。在肝脏疾病患病率增加的背景下，澳大利亚原住民 HCC 的发病率更高，与其他澳大利亚人相比，他们在获得更好的医疗保健结果方面面临着更多的障碍。以前单独使用影像学诊断 HCC 的方法现在受到了挑战，随着个性化医学管理的普及，活检可能变得越来越必要。HCC 的治疗非常复杂，涉及多个学科，多学科团队方法是目前患者护理的标准。新的免疫疗法组合有望为晚期 HCC 患者提供有前途的新治疗选择。然而，澳大利亚在患病率、诊断和服务提供方面的不平等，尤其是在原住民中，需要在采用新的 HCC 管理选择的同时得到纠正。
