Medical treatment of hepatocellular carcinoma: any progress?
BACKGROUND
Hepatocellular carcinoma (HCC) remains one of the most common neoplasms worldwide. Curative treatment options include liver transplantation or resection. Unfortunately, most patients still have unresectable or untransplantable HCC due to disease extension or comorbid factors and are therefore candidate only for palliative treatments.


METHODS
In this review we have analyzed the different medical approaches employed in the treatment of HCC in an attempt to better define their roles.


RESULTS
Palliative medical treatments including systemic chemotherapy, immunotherapy or hormonal manipulation rarely influence survival of the patients. Although a high response rate is often reported with new local therapies such as transcatheter arterial embolization, intraarterial chemotherapy or percutaneous ethanol injection, the real impact of these treatment modalities on patient survival remains to be determined.


CONCLUSIONS
One way to improve the diagnosis of HCC patients would be an appropriate approach to evaluate new drugs or treatment modalities. To answer all the open questions, further trials, possibly randomized, should be conducted on a substantial number of patients with homogeneous prognostic factors.
Department of Medical Oncology, Ospedale Civile, Castelfranco Veneto, Italy.
M
M
Colleoni
F
F
Gaion
G
G
Liessi
G
G
Mastropasqua
P
P
Nelli
P
P
Manente
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000379:methods; D000431:Ethanol / Q000627:therapeutic use; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000628:therapy
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D000431:Ethanol; D005472:Fluorouracil