Current treatment strategy for hepatocellular carcinoma

Area of Science:

• Hepatobiliary Medicine
• Surgical Oncology
• Gastroenterology

Background:

• Early-stage hepatocellular carcinoma (HCC) is increasingly diagnosed due to surveillance programs in high-risk patients.
• Accurate prognostic estimation and patient stratification for HCC present significant clinical challenges.
• Current management requires optimized treatment algorithms for diverse patient subgroups.

Purpose of the Study:

• To review current trends in hepatocellular carcinoma (HCC) management.
• To emphasize tumor staging, treatment algorithms, and outcomes of various treatment modalities.
• To provide a framework for optimal HCC patient care.

Main Methods:

• Review of current practice guidelines, focusing on the Barcelona Clinic Liver Cancer (BCLC) staging system.
• Analysis of treatment modalities including hepatic resection, liver transplantation, percutaneous ablation, and transarterial chemoembolization (TACE).
• Evaluation of prognostic stratification and survival outcomes for different HCC stages and treatments.

Main Results:

• The BCLC staging system effectively stratifies HCC patients into prognostic subgroups for tailored treatment.
• Curative treatments (resection, transplantation, ablation) are reserved for patients with good prognosis.
• For advanced HCC, TACE offers palliation and survival benefits, while distant metastases necessitate palliative care.

Conclusions:

• Favorable survival outcomes are reported for curative HCC treatments like resection, transplantation, and ablation.
• Transarterial chemoembolization (TACE) demonstrates survival benefits for HCC patients, despite less pronounced effects than curative options.
• A comprehensive treatment algorithm integrating all modalities is essential for optimal hepatocellular carcinoma care.