Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 18, 2015; 7(11): 1562-1571
Published online Jun 18, 2015. doi: 10.4254/wjh.v7.i11.1562
Update in management of hepatocellular carcinoma in Eastern population
Kevin Ka Wan Chu, Tan To Cheung
Kevin Ka Wan Chu, Tan To Cheung, Department of Surgery, the University of Hong Kong, Hong Kong, China
Author contributions: Chu KKW and Cheung TT prepared and wrote the manuscript.
Conflict-of-interest: There is no conflict of interest.
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: Tan To Cheung, MBBS (HK), FHKAM (Surgery), FCSHK, FRCS (Edin), Department of Surgery, the University of Hong Kong, 102 Pokfulam Road, Hong Kong, China. tantocheung@hotmail.com
Telephone: +852-22553025 Fax: +852-28165284
Received: November 27, 2014
Peer-review started: November 29, 2014
First decision: January 20, 2015
Revised: February 10, 2015
Accepted: April 10, 2015
Article in press: April 14, 2015
Published online: June 18, 2015
Abstract

Hepatocellular carcinoma (HCC) is one of the commonest malignant tumours in the East. Although the management of HCC in the West is mainly based on the Barcelona Clinic for Liver Cancer staging, it is considered too conservative by Asian countries where the number of HCC patients is huge. Scientific and clinical advances were made in aspects of diagnosis, staging, and treatment of HCC. HCC is well known to be associated with cirrhosis and the treatment of HCC must take into account the presence and stage of chronic liver disease. The major treatment modalities of HCC include: (1) surgical resection; (2) liver transplantation; (3) local ablation therapy; (4) transarterial locoregional treatment; and (5) systemic treatment. Among these, resection, liver transplantation and ablation therapy for small HCC are considered as curative treatment. Portal vein embolisation and the associating liver partition with portal vein ligation for staged hepatectomy may reduce dropout in patients with marginally resectable disease but the midterm and long-term results are still to be confirmed. Patient selection for the best treatment modality is the key to success of treatment of HCC. The purpose of current review is to provide a description of the current advances in diagnosis, staging, pre-operative liver function assessment and treatment options for patients with HCC in the east.

Keywords: Hepatocellular carcinoma, Liver cirrhosis, Treatment, Management, Evidence, Survival, Update

Core tip: Management of hepatocellular carcinoma (HCC) has changed significantly over the past several decades. However, the management of patients has yet to be standardized. As a result of high prevalence of hepatitis B infection in Asia, the experience of the East helped to develop a more aggressive management algorithm. There has been a lot of advancement in terms of diagnosis, management algorithm, staging and treatment methods. This paper will give an update on the management of HCC in the eastern population.