| Abstract: |
Hepatocellular carcinoma (HCC) is the most frequent primary tumor of the liver and its incidence is growing. Most HCCs arise in cirrhotic livers and the treatment options depend on the tumor stage as well as the underlying liver function. Liver resection is usually offered to patients with solitary tumors and well-preserved liver function, while liver transplantation represents the best treatment option for those patients with decompensated cirrhosis and/or multifocal disease, within established guidelines. Other locoregional treatment options such as ablation, including radiofrequency ablation (RFA) or microwave ablation (MWA), transarterial chemoembolization (TACE), transarterial radioembolization (TARE with Y90) and stereotactic body radiation, may also be applied in various clinical scenarios. Systemic treatment for unresectable HCC has largely been limited to sorafenib. However, recent results have demonstrated that levatinib is an equivalent first-line treatment, and several agents have demonstrated efficacy as second-line agents for patients who progress on sorafenib. Checkpoint inhibitors still remain on the horizon with no clear supporting data for their use. In this chapter, we review the current state of the art for the management of HCC. © Springer Nature Switzerland AG 2020. |
