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Primary tumors of the liver represent the sixth most common malignancy worldwide, and the third most common cause of death from cancer. The global incidence of the disease accounts for approximately 626,000 cases annually, with a male-to-female ratio of about 2.4:1. In the United States, approximately 19,160 new tumors of the liver and intrahepatic bile ducts are diagnosed each year, with 16,780 deaths estimated annually. Primary liver cancers rank sixth among the most common cause of cancer deaths in males in the United States. In general these tumors have a poor prognosis, compounded by background liver disease in the majority of patients. Continued improvement in the management of liver cancers is expected. Better imaging studies have become available to screen for hepatic malignancies; liver transplantation has been increasingly applied with its role better defined; and newer therapies such as regional 90Y-microspheres and systemic sorafenib have become available. It is likely that future advances in the control of these malignancies will be focused on prevention, immunization strategies for hepatitis B virus (HBV) and hepatitis C virus (HCV), as well as means to decrease cirrhosis of any origin. Earlier diagnosis by surveillance of patients at risk for hepatocellular carcinoma (HCC) development, improved regional therapy, and systemic targeted therapy will all lead to meaningful progress against this disease.



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