title: Recent advances in the treatment of hepatocellular carcinoma.
abstract: OBJECTIVE
  To provide an up-to-date summary of the recent advances in therapies for hepatocellular carcinoma (HCC).
  
  
  RESULTS
  Surgical resection, liver transplantation, and local ablative therapies such as radiofrequency ablation offer potential cure for tumors detected at an early stage in well selected patients. The role of adjuvant or neoadjuvant therapy is being investigated, but there is no clear evidence supporting its routine use currently. Some have proposed expanding size criteria for transplantation or downstaging tumors detected beyond an early stage, although benefits must be weighed against harms to others on the waiting list. For intermediate-stage HCC, transarterial chemoembolization is the mainstay of treatment, although there is increasing evidence supporting a role for transarterial radioembolization. For advanced HCC, sorafenib is the only systemic therapy to significantly prolong survival in patients with Child A cirrhosis and good performance status. Ongoing trials are evaluating the role of other targeted therapies in patients with advanced HCC.
  
  
  CONCLUSIONS
  There have been advances in HCC treatment options over the last couple of years and there are now potential therapies for most patients with any stage of disease. Treatment decisions must be individualized after accounting for factors such as degree of liver dysfunction and patient performance status.
authors.affiliation: Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas 75390-8887, USA.
authors.forename: Kunjali T
authors.initials: KT
authors.lastname: Padhya
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Marrero
authors.forename: Amit G
authors.initials: AG
authors.lastname: Singal
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003131:Combined Modality Therapy; D055088:Early Detection of Cancer / Q000379:methods; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation; D009367:Neoplasm Staging