Treatment of recurrent hepatocellular carcinoma: The current standards and future perspectives

Hepatocellular carcinoma (HCC) remains one of the commonest cancers worldwide with an overall poor prognosis and survival rates. The rising incidence of liver disease, in particular non-alcoholic fatty liver disease, will account for a continued increase in the rates of liver cancer. The recurrence of HCC has been reported across the different etiologies of liver disease. Unlike primary HCC, there is no agreed consensus or guidance as to the optimum management of recurrent HCC (RHCC). Furthermore, the management of RHCC may prove more challenging compared to primary liver cancer, given the smaller residual liver volume and functions in settings following surgery or transplantation. Various modalities exist for the treatment of primary HCC including resection, liver transplantation, loco-regional and systemic therapies. Nevertheless, the role of such modalities remains unclear in the management of RHCC. In this article, we aim to review the different approaches of the current standards for the management of RHCC. We will also shed some light on the future perspectives in this field.