Abstract
Hepatocellular carcinoma (HCC) represents one of the most challenging potentially curable tumors with high incidence, prevalence and mortality rates. For proper assessment, prognosis estimation and treatment decisions, at least seven important guidelines and staging systems were designated. Proper treatment needs the interaction of multidisciplinary HCC clinic to choose the most appropriate line of treatment. The different modalities of management include resection (surgery or transplantation), local ablation, chemoembolization, radioembolization and molecular targeted therapies with a wide range of investigational drugs that developed after the FDA approved sorafenib. Downstaging and bridging are two important strategies to manage HCC patients who will undergo liver transplantation to improve their postoperative survival. Finally, survival and prognosis depends on several prognostic factors that are either patient related or tumor related. In our study, we aim to provide an updated comprehensive review of the different aspects of liver cancer management starting from staging systems to the different applied treatment modalities.
Highlights
Hepatocellular Carcinoma (HCC) is the sixth most common cancer worldwide, accounting for 7% of all cancers and an estimated incidence of 749,000 new cases every year
The different modalities of management include resection, local ablation, chemoembolization, radioembolization and molecular targeted therapies with a wide range of investigational drugs that developed after the Food and Drug Administration (FDA) approved sorafenib
We aim to provide an updated comprehensive review of the different aspects of liver cancer management starting from staging systems to the different applied treatment modalities
Summary
Hepatocellular Carcinoma (HCC) is the sixth most common cancer worldwide, accounting for 7% of all cancers and an estimated incidence of 749,000 new cases every year. It is considered to be the third cause of cancer related deaths (692,000 cases). The highest incidence rates of HCC (around 85% of cases) are present in East Asia, sub-Saharan Africa, and Melanesia [1]. Management of HCC starts by identifying its stage and underlying liver status choosing the most appropriate line of therapy (surgical, locoregional, radiological and medical) aiming to improve the survival and/or the quality of life of the patient. This review will provide an updated status of the different aspects of liver cancer management from the different staging systems to the applied and future treatment modalities
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