Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 28, 2015; 7(15): 1913-1920
Published online Jul 28, 2015. doi: 10.4254/wjh.v7.i15.1913
Current management of patients with hepatocellular carcinoma
Tatsuo Kanda, Sadahisa Ogasawara, Tetsuhiro Chiba, Yuki Haga, Masao Omata, Osamu Yokosuka
Tatsuo Kanda, Sadahisa Ogasawara, Tetsuhiro Chiba, Yuki Haga, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba 260-8677, Japan
Masao Omata, Yamanashi Hospitals (Central and Kita) Organization, Kofu-shi, Yamanashi 400-8506, Japan
Masao Omata, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Author contributions: Kanda T, Ogasawara S, Chiba T, Haga Y, Omata M and Yokosuka O contributed to this paper.
Conflict-of-interest statement: Dr. Sadahisa Ogasawara, Dr. Tetsuhiro Chiba, Dr. Yuki Haga and Professor Masao Omata have no conflict of interest to declare. Dr. Tatsuo Kanda reports receiving lecture fees from Chugai Pharmaceutical, MSD, Tanabe-Mitsubishi, Daiichi-Sankyo, and Bristol-Myers Squibb, and Professor Osamu Yokosuka reports receiving grant support from Chugai Pharmaceutical, Bayer, MSD, Daiichi-Sankyo, Tanabe-Mitsubishi, and Bristol-Myers Squibb.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tatsuo Kanda, MD, PhD, Associate Professor, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan. kandat-cib@umin.ac.jp
Telephone: +81-43-2262086 Fax: +81-43-2262088
Received: February 20, 2015
Peer-review started: February 22, 2015
First decision: April 27, 2015
Revised: May 2, 2015
Accepted: June 4, 2015
Article in press: June 8, 2015
Published online: July 28, 2015

The current management therapies for hepatocellular carcinoma (HCC) patients are discussed in this review. Despite the development of new therapies, HCC remains a “difficult to treat” cancer because HCC typically occurs in advanced liver disease or hepatic cirrhosis. The progression of multistep and multicentric HCC hampers the prevention of the recurrence of HCC. Many HCC patients are treated with surgical resection and radiofrequency ablation (RFA), although these modalities should be considered in only selected cases with a certain HCC number and size. Although there is a shortage of grafts, liver transplantation has the highest survival rates for HCC. Several modalities are salvage treatments; however, intensive care in combination with other modalities or in combination with surgical resection or RFA might offer a better prognosis. Sorafenib is useful for patients with advanced HCC. In the near future, HCC treatment will include stronger molecular targeted drugs, which will have greater potency and fewer adverse events. Further studies will be ongoing.

Keywords: Hepatocellular carcinoma, Living donor liver transplantation, Radiofrequency ablation, Surgical resection

Core tip: Liver transplantation is the first-line treatment of hepatocellular carcinoma (HCC). Surgical resection and radiofrequency ablation (RFA) are second-line HCC treatments. Surgical resection and RFA should only be considered for selected cases. Sorafenib administration, transarterial chemoembolization, stereotactic body radiation treatments, or proton or carbon ion treatments are available as salvage treatments for HCC. Laparoscopic liver resection appears to offer at least a short-term benefit in selected HCC patients. These HCC treatments should be carefully selected or combined in clinical practice.