Journal: Seminars in liver disease
This review article outlines contemporary, practice-oriented guidance for managing hepatocellular carcinoma (HCC) across the disease continuum.
Key points:
- Systemic therapy: Immune-based treatments have become the backbone of systemic management, reflecting a shift away from traditional monotherapy TKIs toward immunotherapy-containing regimens.
- Surgical management: Advances such as robotic surgery have expanded resection eligibility to a subset of patients previously considered inoperable, including some with challenging tumor locations or portal hypertension, provided careful selection.
- Downstaging strategies: Downstaging (via locoregional or other treatments) is highlighted as an accepted approach in selected patients, with post-transplant or post-treatment outcomes comparable to those meeting conventional listing criteria upfront.
- Complexity of care: The growing array of therapeutic options has increased management complexity, emphasizing the need for multidisciplinary tumor boards and structured shared decision-making.
- Scope of recommendations: The review offers concise, practical guidance spanning:
- Risk stratification and identification of at-risk populations
- Early detection and surveillance strategies
- Diagnostic work-up
- Treatment selection among curative, locoregional, and systemic approaches
Overall, the article serves as a succinct, clinically oriented overview to support real-world decision-making in modern HCC care.