title: Advances in Local and Systemic Therapies for Hepatocellular Cancer.
abstract: Global incidence and mortality of hepatocellular carcinoma (HCC) has increased over the past two decades. Although transplantation and surgical resection offer a chance for cure and long-term survival, most patients present with more advanced tumor stage when these therapies are not possible. Although rarely curative, locoregional therapy with transarterial chemoembolization or radioembolization offers a survival benefit for those with liver-isolated HCC who are not amenable to curative therapies. Patients with metastatic disease or macrovascular invasion are treated with systemic therapy; however, median survival remains below 1 year. Patients with severe liver dysfunction or poor performance status should be treated with best supportive care given poor prognosis and no survival benefit for treatment. Lack of predictive and prognostic biomarkers in intermediate and advanced HCC tumors has hampered integration of clinical and molecular data to aid tailoring treatment decisions. However, with increasingly complex treatment decisions, optimal outcomes are achieved through multidisciplinary care.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Mokdad
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
authors.forename: Amit G
authors.initials: AG
authors.lastname: Singal
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA. adam.yopp@utsouthwestern.edu.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Yopp
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000401:mortality / Q000639:trends; D003131:Combined Modality Therapy; D055088:Early Detection of Cancer; D006498:Hepatectomy / Q000401:mortality / Q000639:trends; D006801:Humans; D033183:Interdisciplinary Communication; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation / Q000401:mortality / Q000639:trends; D009367:Neoplasm Staging / Q000379:methods; D015996:Survival Rate
keywords: Hepatocellular carcinoma; Liver cancer; Liver disease; Locoregional therapy; Staging; Systemic therapy