Hepatocellular Carcinoma

It is expected that the number of patients who have HCC will continue to increase over the next 2 decades. Currently, most patients who have HCC present with advanced disease, and the overall survival has improved minimally over the last 20 years, making early detection crucial. Patients who have cirrhosis are at the highest risk for developing HCC and constitute the population in which surveillance should be performed. AFP and ultrasound are the major means of surveillance, although evidence of their efficacy is lacking. Once HCC is diagnosed, staging is critical to determine prognosis and the treatment plan. The BCLC is the preferred method for staging and for guiding therapy. Resection, transplantation, and percutaneous ablation are considered curative because of their excellent 5-year survival rates. Currently, there is no standard therapy for advanced HCC.