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World J Gastroenterol. Apr 21, 2014; 20(15): 4115-4127
Published online Apr 21, 2014. doi: 10.3748/wjg.v20.i15.4115
Hepatocellular carcinoma review: Current treatment, and evidence-based medicine
Ali Raza, Gagan K Sood
Ali Raza, Department of Internal Medicine, St. Luke’s Episcopal Hospital, Baylor College of Medicine, Houston, TX 77030, United States
Gagan K Sood, Division of Gastroenterology and Hepatology, Baylor College of Medicine, St. Luke’s Liver Center, Houston, TX 77030, United States
Author contributions: Raza A performed the data research and helped writing the manuscript; Sood GK designed the manuscript; performed the research; helped writing the manuscript and critically analyzed the manuscript.
Correspondence to: Gagan K Sood, MD, Division of Gastroenterology and Hepatology, Baylor College of Medicine, St. Luke’s Liver Center, 6620 Main Street, Suite 1425, Baylor Clinic, Houston, TX 77030, United States. gksood@bcm.edu
Telephone: +1-832-3551400 Fax: +1-713-6102479
Received: September 28, 2013
Revised: December 6, 2013
Accepted: March 6, 2014
Published online: April 21, 2014
Abstract

Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide. Multiple treatment options are available for HCC including curative resection, liver transplantation, radiofrequency ablation, trans-arterial chemoembolization, radioembolization and systemic targeted agent like sorafenib. The treatment of HCC depends on the tumor stage, patient performance status and liver function reserve and requires a multidisciplinary approach. In the past few years with significant advances in surgical treatments and locoregional therapies, the short-term survival of HCC has improved but the recurrent disease remains a big problem. The pathogenesis of HCC is a multistep and complex process, wherein angiogenesis plays an important role. For patients with advanced disease, sorafenib is the only approved therapy, but novel systemic molecular targeted agents and their combinations are emerging. This article provides an overview of treatment of early and advanced stage HCC based on our extensive review of relevant literature.

Keywords: Hepatocellular carcinoma, Trans-arterial chemoembolization, Drug-eluting beads, Radiofrequency ablation, Liver transplantation, Chemotherapy, Sorafenib, Radioembolization

Core tip: The article discusses the current evidence based treatment of hepatocellular carcinoma. Specific focus is placed on emerging systemic molecular targeted therapies.