Published online Feb 27, 2015. doi: 10.4254/wjh.v7.i2.165
Peer-review started: July 16, 2014
First decision: August 28, 2014
Revised: September 30, 2014
Accepted: November 17, 2014
Article in press: November 19, 2014
Published online: February 27, 2015
Core tip: Hepatocellular carcinoma is a primary liver tumor that usually develops in a background of chronic liver disease and fibrosis. It is the underlying chronic inflammation that creates an environment that not only causes but also enhances the formation and growth of tumors. The stromal compartment-including hepatic stellate cells, macrophages and endothelial cells-actively contribute to tumorigenesis, while the tumor itself influences these cells to create a background that is beneficial for tumor growth. This review focuses on the interplay between stroma and tumor cells, as well as therapeutic strategies that aim to target these complex interactions.