Liver malignancy, primary and secondary
Metastases versus primary liver cancer, who gets HCC surveillance under the 2025 Australian guideline, diagnosing HCC on multiphase imaging without biopsy, BCLC staging and treatment, first-line immunotherapy combinations, cholangiocarcinoma and resectable colorectal metastases.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Metastases are the commonest malignant liver lesions in Australia. Of primary liver cancers, about 80 to 90% are hepatocellular carcinoma (HCC) and most of the rest intrahepatic cholangiocarcinoma.
- Liver cancer has been one of the fastest-rising causes of cancer death in Australia. Drivers are hepatitis B in people born in the Asia-Pacific and Africa, hepatitis C, alcohol and MASLD.
- Most HCC arises in cirrhosis, so surveillance, diagnosis and treatment all depend on liver function. Cirrhosis care is in Chronic liver disease and cirrhosis.
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Sources
- George J et al. Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia: summary of recommendations. Med J Aust 2025;223(8):426-36AU/NZCancer Council Australia (NHMRC-approved guideline), 2025
- EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma. J Hepatol 2025;82(2):315-74European Association for the Study of the Liver, 2025
- Vogel A et al. Hepatocellular carcinoma: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2025;36(5):491-506European Society for Medical Oncology, 2025
- Reig M et al. BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update. J Hepatol 2022;76:681-93Barcelona Clinic Liver Cancer group (Journal of Hepatology), 2022
- eviQ Cancer Treatments Online (hepatobiliary protocols)AU/NZCancer Institute NSW
- Finn RS et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma (IMbrave150). N Engl J Med 2020;382:1894-905New England Journal of Medicine, 2020
- Cheng AL et al. Updated efficacy and safety data from IMbrave150: atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma. J Hepatol 2022;76(4):862-73Journal of Hepatology, 2022
- Abou-Alfa GK et al. Tremelimumab plus durvalumab in unresectable hepatocellular carcinoma (HIMALAYA). NEJM Evid 2022;1(8)NEJM Evidence, 2022
- Oh DY et al. Durvalumab plus gemcitabine and cisplatin in advanced biliary tract cancer (TOPAZ-1). NEJM Evid 2022;1(8)NEJM Evidence, 2022
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy