Treatment of hepatocellular carcinoma in cirrhotic patients

Hepatocellular carcinoma (HCC) is a frequent tumor with increasing incidence in relation with hepatitis C virus infection endemic. Known treatments are rather unsatisfactory and only liver transplantation, surgical resection or percutaneous ablation are considered as curative options for HCCs of small size. No palliative therapeutic option has clearly demonstrated any benefit on overall survival. While standard antineoplastic options as systemic chemotherapy and external radiotherapy are unsatisfactory, conformal radiotherapy and proton therapy might be of interest. Interferon and differentiating agents could probably play a key role in modulating liver oncogenesis while they have rather poor efficacy for controlling tumor growth. Primary and secondary chemoprophylaxis of HCC as well as neoadjuvant and adjuvant options have to be developed to improve the prognosis of this tumor.