Hepatocellular carcinoma clinical update: Current standards and therapeutic strategies

Hepatocellular carcinoma (HCC) accounts for the vast majority of primary hepatic malignancies. The overall incidence of this disease has always been significant, but in recent years it has continued to rise, now making HCC one of the leading causes of cancer deaths worldwide. Fortunately, research into the mechanisms of carcinogenesis and treatment options for this disease has also been progressing rapidly. Although the future for new insights and therapies appears more promising than ever, it also remains important to understand both the nature of HCC and the current state-of-the-art for treating affected patients. Although surgery is often considered to be a first choice, many patients present with extensive disease and are therefore not operative candidates. Fortunately, significant clinical advances over the last decade have contributed a number of new or improved treatment options. Many of these treatments require expertise from a variety of different clinical subspecialties. Indeed, managing patients with HCC has rapidly become a multi-modality, multi-disciplinary endeavor in which the details of each individual’s circumstance can greatly impact outcomes, and strategies can be quite nuanced. The purpose of this review is to provide a perspective on the disease itself, the patients who become afflicted, the spectrum of currently available treatment options, and the strategies for their optimal implementation. Such knowledge can be critically important as new data become available on the research front.