Management of primary liver cancer

1) Hepatocellular carcinomas represent approximately 90% of all primary cancers of the liver. In 80% of cases, these cancers develop in patients with cirrhosis (of viral origin or due to other causes); 2) Numerous treatments have been proposed (transplantation, surgical resection, percutaneous ablation, arterial embolisation, chemotherapy) either alone or in combination; 3) Adverse effects are frequent, varied and often serious. Efficacy is highly variable, depending on tumour size, liver function and the patient's health status. As of 2008, little comparative evaluation of these treatments has been performed; 4) In practice, surgery is the treatment of choice for small, solitary tumours. In other cases, choosing the most appropriate treatment is particularly tricky, and depends on the individual case.