The Chengdu system for recurrent hepatocellular carcinoma: A step in the right direction

Liver cancer is the fourth leading cause of cancer-related death worldwide. Hepatocellular carcinoma (HCC), the most prevalent cause of primary liver cancer, is observed highest in the Far East, South-Eastern Asia and East Africa (1). In most endemic regions this is secondary to the prevalence of specific risk factors including chronic hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection and aflatoxin-exposure (1,2). The development of HBV vaccination and programmes to reduce HBV transmission has reduced the risk of HCC in high-risk Asian countries (1). Global incidence of HCC however continues to rise and major contributory factors to this are alcohol misuse and the obesity epidemic, resulting in non-alcoholic fatty liver disease, in Western nations (1,2).