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Management of hepatocellular carcinoma

  • P. Fitzmorris
  • M. Shoreibah
  • B. S. Anand
  • A. K. Singal
Review – Clinical Oncology

Abstract

Purpose

Hepatocellular carcinoma (HCC), a common cause for cancer-related death, is increasing worldwide. Over the past decade, survival and quality of life of HCC patients have significantly improved due to better prevention strategies, early diagnosis, and improved treatment options. We performed this narrative review to synthesize current status on the HCC management.

Methods

Literature search for publications especially over the last decade, which has changed the paradigm on the management of HCC.

Results

Hepatitis B vaccination and treatment of chronic hepatitis B and C are important measures for HCC prevention. Screening and surveillance for HCC using ultrasonogram and alpha-fetoprotein estimation are directed toward cirrhotics and hepatitis B patients at high risk of HCC. If detected at an early stage, curative treatments for HCC can be used such as tumor resection, ablation and liver transplantation. HCC patients without curative options are managed by loco-regional therapies and systemic chemotherapy. Loco-regional treatments include trans-arterial chemoembolization, radioembolization and combinations of loco-regional plus systemic therapies. Currently, sorafenib is the only FDA-approved systemic therapy and newer better chemotherapeutic agents are being investigated. Palliative care for terminally ill patients with metastatic disease and/or poor functional status focusses on comfort care and symptom control.

Conclusions

In spite of significant advancement in HCC management, its incidence continues to rise. There remains an urgent need to continue refining understanding of HCC and develop strategies to increase utilization of the available preventive measures and curative treatment modalities for HCC.

Keywords

Prevention Transplantation Loco-regional therapy Systemic therapy 

Notes

Conflict of interest

We declare that we have no conflict of interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • P. Fitzmorris
    • 1
  • M. Shoreibah
    • 2
  • B. S. Anand
    • 3
  • A. K. Singal
    • 2
  1. 1.Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Division of Gastroenterology and HepatologyUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Division of GI and HepatologyMichael DeBakey VA Medical CenterHoustonUSA

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