Shaping the future management of hepatocellular carcinoma

Several advances in recent years have led to improved surveillance, diagnostic, and treatment options for hepatocellular carcinoma (HCC). Despite these advances, care for this malignancy remains suboptimal, in part because of poor adherence to established guidelines. When diagnosed at an early stage, outcomes for HCC are positive; however, use of appropriate screening techniques and surveillance of at risk patients is still not widely employed. Although a multidisciplinary care team is considered an essential part of successful HCC treatment, fewer than half of the patients with HCC in the United States receive multidisciplinary care. The current suboptimal utilization of potentially curative treatments, including those recommended by treatment guidelines, can be linked to the absence of multidisciplinary care. Additionally, the lack of prognostic and predictive biomarkers for HCC remains challenging, particularly as therapeutic approaches in advanced disease evolve to the use of molecularly targeted agents. Much research is currently focused on the identification of biomarkers for HCC, but improvements in adherence to guidelines for surveillance and appropriate use of available therapies is necessary before care for patients with HCC will improve.