Review
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 27, 2025; 17(8): 107873
Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.107873
Modern approach to hepatocellular carcinoma treatment
Francesco Cortese, Fotis Anagnostopoulos, Maria Vittoria Bazzocchi, Silvio Caringi, Antonio Rosario Pisani, Matteo Renzulli, Ioannis Paraskevopoulos, Letizia Laera, Alessia Surgo, Stavros Spiliopoulos, Riccardo Memeo, Riccardo Inchingolo
Francesco Cortese, Riccardo Inchingolo, Interventional Radiology Unit, "F Miulli" Regional General Hospital, Acquaviva delle Fonti 70021, Italy
Fotis Anagnostopoulos, Stavros Spiliopoulos, The Second Radiology Department, National and Kapodistrian University of Athens, Chaidari Athens 12461, Greece
Maria Vittoria Bazzocchi, Radiology Unit, Morgagni-Pierantoni Hospital, Forlì 47122, Italy
Silvio Caringi, Department of Sugery Roma, Università degli studi di Roma “Tor Vergata”, Roma 00133, Italy
Antonio Rosario Pisani, Interdisciplinary Department of Medicine, Section of Nuclear Medicine, University of Bari “Aldo Moro”, Bari 70121, Italy
Matteo Renzulli, Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, Radiology Unit, Bologna 40137, Italy
Ioannis Paraskevopoulos, Department of Diagnostic and Interventional Radiology, University Hospital of Ioannina, Ioannina 12461, Greece
Letizia Laera, Department of Oncology, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti 70021, Italy
Alessia Surgo, Department of Radiation Oncology, “F. Miulli” Regional General Hospital, Acquaviva delle Fonti 70021, Italy
Alessia Surgo, Riccardo Memeo, Riccardo Inchingolo, Department of Medicine and Surgery, LUM University, Casamassima 70021, Italy
Riccardo Memeo, Department of Surgery, General Regional Hospital F. Miulli, Acquaviva delle Fonti 70021, Italy
Author contributions: Cortese F, Inchingolo R and Memeo R designed the research; Anagnostopoulos F, Caringi S, Pisani AR and Laera L performed the research; Paraskevopoulos I, Renzulli M contributed new reagents or analytic tools; Spiliopuolos S, Bazzocchi MV, and Surgo A wrote the paper.
Conflict-of-interest statement: All the authors are aware of the content of the manuscript and have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Riccardo Inchingolo, MD, Assistant Professor, Director, Interventional Radiology Unit, "F Miulli" Regional General Hospital, Via di Santeramo, Acquaviva delle Fonti 70021, Italy. riccardoin@hotmail.it
Received: April 13, 2025
Revised: May 25, 2025
Accepted: July 2, 2025
Published online: August 27, 2025
Processing time: 138 Days and 5.1 Hours
Abstract

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, necessitating innovative treatment strategies. Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC; however, advances in imaging and minimally invasive techniques have improved patient selection and outcomes. Additionally, the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC. This review highlights the efficacy of agents such as tyrosine kinase inhibitors, alongside emerging options like immune checkpoint inhibitors, which have shown promise in clinical trials. Furthermore, the role of locoregional therapies, including ablation in the setting of combined treatment, transarterial chemoembolization and transarterial radioembolization with flow catheters, cone-beam computed tomography and 4D navigation guidance, is examined in the context of bridging therapies for patients awaiting surgical intervention. The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes. Future directions for HCC treatment are discussed, including the potential of novel biomarkers in prognosis and treatment response. This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.

Keywords: Hepatocellular carcinoma; Robotic resection; Transplantation; Locoregional treatments; Radioembolization; Systemic treatment; Stereotactic body radiotherapy

Core Tip: Hepatocellular carcinoma is the sixth most common cancer and is the fourth leading cause of cancer-related deaths worldwide. Its management can be challenging and relies on a multidisciplinary approach involving hepatobiliary surgeons, oncologists, hepatologists, endoscopists, interventional radiologists, radiotherapists and radiologists. This review investigates different treatments, with a special focus on most modern approaches.