Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

Table 3 Treatment options for non-cirrhotic hepatocellular carcinoma

Treatment	Comments
Antiviral therapy	If HBV or HCV are identified as potential causes of NCHCC, aggressive treatment should be pursued. Entecavir, tenofovir have been used for HBV and DAA agents are used for HCV infection
Surgery	Mainstay for the treatment of NCHCC. BCLC staging cannot be used for NCHCC patients. Tumor size, elevated bilirubin level, low platelet count, vascular invasion can predict prognosis in NCHCC individuals
Locoregional therapy	Limited data available in NCHCC patients. Isolated cases and case series showed improved prognosis with these treatment options
Systemic therapy	Multikinase inhibitors (sorafenib, regorafenib), immunotherapy (nivolumab), chemotherapeutic agents (epirubicin, cisplatin, 5-fluororuacil, capecitabine, docetaxel, GEMOX) have been used in NCHCC with various success

Potential treatment options for non-cirrhotic hepatocellular carcinoma. Antiviral therapy is indicated if hepatitis C virus or hepatitis C virus is identified as a potential cause. While surgery remains the mainstay of the treatment, locoregional and systemic therapy options have been tried. HCC: Hepatocellular carcinoma; DAA: Direct acting antiviral; NCHCC: Non cirrhotic hepatocellular carcinoma; BCLC: Barcelona-Clinic Liver Cancer; HBV: Hepatitis B virus; HCV: Hepatitis C virus; GEMOX: Gemcitabine and oxaliplatin regimen.