Hepatocellular carcinoma : the clinical problem

Hepatocellular carcinoma (HCC) is one of the most common malignancies, responsible for over one million deaths annually world wide. The causal relationship between HCC and cirrhosis is clear, with the majority of cases of HCC occurring in patients with cirrhotic liver disease. Survival of untreated individuals is poor. At this stage, surgical resection provides the only chance of cure, but it is not suitable for the majority of patients in whom the tumor pathology or the underlying liver disease makes surgery hazardous. For most patients, nonsurgical treatment is the only option and this has led to the popularization of various regional and systemic modalities. Tumor stage is a significant predictor of survival and screening high-risk groups allows detection of tumors at an earlier stage, thereby increasing the likelihood of effective treatment.