Published online Jul 28, 2015. doi: 10.4254/wjh.v7.i15.1913
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.
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.