[Hepatocellular carcinoma: increasing incidence and optimized management]

Hepatocellular carcinoma is the main type of primary liver cancer. It is a major complication of chronic liver diseases, mainly cirrhosis. High increase in incidence and mortality has been observed in industrialized countries for about 30 years, as well as major improvement in the understanding of carcinogenesis and diagnostic and therapeutic management of patients: ultrasonographic screening of patients with cirrhosis, noninvasive (probabilistic) diagnosis mainly based on imaging procedures, improvement of liver transplantation results, development of tumor destruction using percutaneous radiofrequency, and more recently slight but significant increase in survival in patients treated with sorafenib. Nevertheless, some progress is still needed in order to improve significantly the incidence and the mortality of patients with hepatocellular carcinoma: widespread and improvement of ultrasonographic screening in patients with cirrhosis, effective chemoprevention, expanded indications of liver transplantation, prevention and treatment of cancer recurrences after surgical resection or radiofrequency, and methodological improvement in assessment of new treatments.