[Hepatocellular carcinoma: increasing incidence and optimized management]

Area of Science:

• Hepatology
• Oncology
• Gastroenterology

Context:

• Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer.
• It frequently arises as a complication of chronic liver diseases, particularly cirrhosis.
• A notable rise in HCC incidence and mortality has been observed in industrialized nations over the past three decades.

Purpose:

• To review recent advancements in the understanding, diagnosis, and management of hepatocellular carcinoma.
• To identify areas requiring further research and development to improve patient outcomes.

Summary:

• Significant progress has been made in ultrasonographic screening for cirrhotic patients.
• Noninvasive diagnostic methods, primarily imaging-based, have improved.
• Therapeutic options have advanced, including enhanced liver transplantation success rates, percutaneous radiofrequency ablation, and the introduction of sorafenib, leading to modest survival improvements.

Impact:

• Despite progress, enhanced ultrasonographic screening and effective chemoprevention strategies are crucial.
• Expanding liver transplantation indications and managing post-treatment cancer recurrence are key challenges.
• Methodological improvements in evaluating novel treatments are necessary to further reduce HCC incidence and mortality.