Hepatocellular carcinoma review: current treatment, and evidence-based medicine

World J Gastroenterol. 2014 Apr 21;20(15):4115-27. doi: 10.3748/wjg.v20.i15.4115.


Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide. Multiple treatment options are available for HCC including curative resection, liver transplantation, radiofrequency ablation, trans-arterial chemoembolization, radioembolization and systemic targeted agent like sorafenib. The treatment of HCC depends on the tumor stage, patient performance status and liver function reserve and requires a multidisciplinary approach. In the past few years with significant advances in surgical treatments and locoregional therapies, the short-term survival of HCC has improved but the recurrent disease remains a big problem. The pathogenesis of HCC is a multistep and complex process, wherein angiogenesis plays an important role. For patients with advanced disease, sorafenib is the only approved therapy, but novel systemic molecular targeted agents and their combinations are emerging. This article provides an overview of treatment of early and advanced stage HCC based on our extensive review of relevant literature.

Keywords: Chemotherapy; Drug-eluting beads; Hepatocellular carcinoma; Liver transplantation; Radioembolization; Radiofrequency ablation; Sorafenib; Trans-arterial chemoembolization.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular / therapy*
  • Catheter Ablation / methods
  • Chemoembolization, Therapeutic / methods
  • Clinical Trials as Topic
  • Combined Modality Therapy / methods
  • Evidence-Based Medicine
  • Humans
  • Liver Neoplasms / therapy*
  • Liver Transplantation
  • Molecular Targeted Therapy / methods
  • Niacinamide / analogs & derivatives
  • Niacinamide / therapeutic use
  • Phenylurea Compounds / therapeutic use
  • Signal Transduction
  • Sorafenib
  • Treatment Outcome


  • Phenylurea Compounds
  • Niacinamide
  • Sorafenib