Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.566
Peer-review started: August 11, 2014
First decision: August 28, 2014
Revised: October 6, 2014
Accepted: December 29, 2014
Article in press: December 29, 2014
Published online: March 27, 2015
Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the third cause of tumor associated deaths worldwide. HCC incidence rates are increasing in many parts of the world including developing and developed countries. Potentially curative treatments for HCC are resection and liver transplantation, but these are only suitable for patients with small tumors, meeting strict pre-defined criteria, or well-compensated liver disease. Early diagnosis of HCC can be achieved by surveillance of at-risk populations. For patients with non-resectable disease treatments modalities include loco-ablative and systemic therapies. In this review we focus on treatment options in HCC and their allocation. Although significant research is in progress, to this date, the results are unsatisfactory with limited long-term survival. In the fight against this deadly disease, there is still a long way to go.
Core tip: We chose to focus on the aspect of treatment modalities of hepatocellular carcinoma (HCC) and discuss the benefits and disadvantages of each modality. We report on the diversity of treatments and the allocation of patients with HCC to the different modalities according to the Barcelona-Clinic Liver Cancer. Moreover, we discuss novel treatments currently under investigation and not yet recommended by acceptable guidelines.