Published online Nov 18, 2015. doi: 10.4254/wjh.v7.i26.2648
Peer-review started: April 2, 2015
First decision: May 13, 2015
Revised: May 19, 2015
Accepted: October 14, 2015
Article in press: November 4, 2015
Published online: November 18, 2015
Hepatocellular carcinoma (HCC) is rapidly becoming one of the most prevalent cancers worldwide. With a rising rate, it is a prominent source of mortality. Patients with advanced fibrosis, predominantly cirrhosis and hepatitis B are predisposed to developing HCC. Individuals with chronic hepatitis B and C infections are most commonly afflicted. Different therapeutic options, including liver resection, transplantation, systemic and local therapy, must be tailored to each patient. Liver transplantation offers leading results to achieve a cure. The Milan criteria is acknowledged as the model to classify the individuals that meet requirements to undergo transplantation. Mean survival remains suboptimal because of long waiting times and limited donor organ resources. Recent debates involve expansion of these criteria to create options for patients with HCC to increase overall survival.
Core tip: Hepatocellular carcinoma (HCC) is the prominent Primary Hepatic tumor. Survival rates average between 6 and 20 mo, making Liver transplantation is the most efficient treatment. The established Milan Criteria is now widely accepted around the world for choosing patients suffering with HCC as liver transplant candidates. Due to high mortality rates, additional variables and tumor characteristics have been researched (example, University of California, San Francisco Criteria) in order to include more patients as candidates, so as to increase overall survival. In this comprehensive review, the pathophysiology, diagnostic modalities, and treatment options are thoroughly discussed.