Locoregional Therapies in the Management of Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy in the world, with over 14 million cases in 2012 and an expected growth to 22 million over the next 20 years [1-3]. It develops secondary to intrinsic liver diseases such as viral hepatitis, alcoholic cirrhosis, steatohepatitis, biliary cirrhosis, or other rarer causes. It represents the third most common etiology of cancer-related deaths in the world and the seventh most common etiology in the United States [3, 4]. As most patients have concomitant chronic liver disease leading to the development of HCC, management of the disease becomes more complicated. Staging and treatment options are impacted not only by the extent of the tumor but also by the patient’s liver function and performance status. Because the majority of patients present with unresectable disease, locoregional therapies, including image-guided percutaneous ablation and image-guided transcatheter tumor therapies, play an important role in the management of patients with HCC.