Management of hepatocellular carcinoma. Where are we now? What's next?

摘要

With 6,000 new cases per year in France and nearly 700,000 new cases per year worldwide, HCC is a frequent cancer occurring in more than 90% of cases on underlying liver disease. Both diseases (cirrhosis and HCC) are involved in patients morbidity and mortality. The prognosis of HCC on cirrhosis is thus generally poor, but mainly varies depending on the stage of the tumor. Despite this poor prognosis, many therapeutic options are available for HCC patients. The curative treatments include orthotopic liver transplantation, surgical resection and radiofrequency thermal ablation. The palliative treatments include transcatheter arterial chemoembolization and more recently a systemic treatment with a new multikinase inhibitor: the sorafenib. However, many questions still need to be address to optimize the therapeutic management of this disease. This review analyses the state of the art in HCC treatment and raises the main questions that clinical trials will have to answer in the future.