Current approach to hepatocellular carcinoma

Area of Science:

• Hepatology
• Oncology
• Surgical Oncology

Background:

• Hepatocellular carcinoma (HCC) represents 80% of primary liver cancers and is the fourth leading cause of cancer-related mortality worldwide.
• Current treatment paradigms for HCC involve surgical resection, liver transplantation, and locoregional therapies, each with specific indications.

Purpose of the Study:

• To review and delineate the established and emerging treatment strategies for Hepatocellular Carcinoma (HCC).
• To clarify the optimal management pathways for HCC based on patient characteristics, including the presence or absence of cirrhosis.

Main Methods:

• Review of current clinical guidelines and landmark studies in HCC management.
• Analysis of treatment outcomes for partial hepatectomy, liver transplantation, and locoregional therapies.

Main Results:

• Partial hepatectomy is the preferred curative treatment for HCC in patients without cirrhosis.
• Liver transplantation is the established gold standard for cirrhotic patients with HCC, excluding those with extrahepatic disease or macrovascular invasion.
• Locoregional therapy serves as an option for non-surgical candidates, with its adjuvant role requiring further investigation.

Conclusions:

• Treatment selection for HCC is highly dependent on the absence or presence of underlying cirrhosis and disease extent.
• Established surgical options provide the best outcomes for resectable HCC, while transplantation addresses advanced disease in cirrhotic patients.
• Further prospective research is necessary to define the precise role of locoregional therapies, particularly as adjuvant treatment for HCC.