Current surgical treatment strategies for hepatocellular carcinoma in North America

Table 2 Current indications of commonly used treatment options for hepatocellular carcinoma

	Current indications
Hepatic resection	Treatment of choice in patients with resectable disease and absence of cirrhosis
	Indicated in selected patients with limited disease and early cirrhosis (Child-Pugh A)
	Limited role as a bridge to OLT
OLT	Standard therapy for patients with HCC and Cirrhosis within Milan criteria
	OLT may be indicated in select patients with tumors outside Milan criteria but within UCSF criteria
	Indicated in select patients with stage III and IV HCC downstaged to within Milan criteria with use of neo-adjuvant therapy
Non resectional ablative therapies (RFA, microwave, TACE, TAE, HIFU etc.)	Indicated as primary therapy only in patients with HCC who are not candidates for curative resection or OLT
	Increasingly used alone or in combination as bridging therapy in patients awaiting OLT or to downstage stage advanced stage disease to within Milan criteria
	Established role in palliative treatment of HCC (not discussed in this paper)

HCC: Hepatocellular carcinoma; OLT: Orthotopic liver transplant; UCSF: University of California San Francisco.