Hepatocellular carcinoma, the most common form of liver cancer, is steadily increasing in North Carolina. This deadly cancer is particularly common in patients with advanced types of liver disease, such as metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease.
Andrew Moon, MD, MPH, a hepatologist at UNC Health and research member of UNC Lineberger Comprehensive Cancer Center, is dedicated to improving liver cancer outcomes in North Carolina-and it all starts with early detection.
"In light of the increasing burden of liver disease and liver cancer in our state, it is essential to better understand and address gaps in hepatocellular carcinoma risk-stratification, screening and linkage to treatment," said Moon.
Moon just initiated a new study alongside PI Louise Henderson, PhD, professor of radiology and co-leader of the UNC Lineberger Cancer Epidemiology Research Program, entitled "Early detection of liver cancer among patients with cirrhosis and metabolic dysfunction-associated steatotic liver disease (MASLD)".
Funded through a $400,000 R21 grant from the National Cancer Institute and the National Institutes of Health, Moon and Henderson will establish a population-based surveillance registry for liver cancer.
Andrew Moon, MD, MPH
and Louise Henderson, PhD.
Researchers will use novel methods to identify patients with MASLD who are at higher risk for liver cancer and may benefit from screening. The goal is to help detect liver cancer earlier, when treatment may be more effective. The state of liver cancer detection and treatments available are one of the strongest factors predicting how long patients survive.
Early-stage liver cancer is commonly treated with thermal ablation (burning or freezing the tumor), by surgically removing the cancerous tumor, or via a liver transplant.
But a new paper published by researchers at UNC Lineberger Comprehensive Cancer and the Barcelona Clinic Liver Cancer (BCLC) in Barcelona, Spain, has shown that a type of radiation therapy might be just as successful in terms of lengthening survival in patients with very early- or early-stage liver cancer.
The study, which was published by Moon and radiation oncologist Ted Yanagihara, MD, PhD in the Journal of Clinical Oncology, found that external beam radiation therapy (EBRT) has similar survival outcomes compared to surgical removal, thermal ablation, and other similar therapies.
A total of 4,913 patients with liver cancer received EBRT for the study. Patients with very early-stage liver cancer had an average survival of 6.8 years, whereas those with early-stage cancer had an average survival of 4.6 years.
Theodore (Ted) Yanagihara, MD, PhD
The study, which had the largest multinational cohort of patients with liver cancer treated with this type of therapy, shows that external beam radiation therapy could be effective for patients with very early- or early-stage liver cancer, and should be considered in treatment algorithms.
Data from this study contributed to EBRT's inclusion in the recently updated Barcelona Clínic Liver Cancer (BCLC) guidelines that doctors worldwide use to determine disease staging and treatment strategies for liver cancer. Yanagihara was also co-author on the BCLC paper announcing the updated guidelines.
