Neoadjuvant therapy and immunotherapy strategies for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the most common cancers with high mortality rate worldwide. Due to aggressive and invasive characteristics of HCC, poor prognosis is often displayed at advanced stages while therapeutic options are limited. Liver resection is still an essential curative-intent treatment in HCC management, while locoregional and systematic therapies made promising advances that may improve the proportion and outcomes of patients who are surgical candidates. In this review, we discussed status of currently available neoadjuvant treatments aimed at improving resectability and reducing recurrence rates. More than ever, in order to implement this therapeutic concepts and exploit the full potential of neoadjuvant treatment strategies, it is of utmost importance to use more high-level evidence to guide treatment decision making. Unfortunately, the use of preoperative treatments is not sponsored by tough evidence and consensus guidelines are absent.