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HPB Surgery
Volume 2012 (2012), Article ID 154056, 8 pages
http://dx.doi.org/10.1155/2012/154056
Review Article

Contemporary Strategies in the Management of Hepatocellular Carcinoma

Institute of Liver Studies, King’s College Hospital, Denmark Hill, London SE5 9RS, UK

Received 12 July 2012; Accepted 17 September 2012

Academic Editor: Andrea Lauterio

Copyright © 2012 Shirin Elizabeth Khorsandi and Nigel Heaton. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Liver transplantation is the treatment of choice for selected patients with hepatocellular carcinoma (HCC) on a background of chronic liver disease. Liver resection or locoregional ablative therapies may be indicated for patients with preserved synthetic function without significant portal hypertension. Milan criteria were introduced to select suitable patients for liver transplant with low risk of tumor recurrence and 5-year survival in excess of 70%. Currently the incidence of HCC is climbing rapidly and in a current climate of organ shortage has led to the re-evaluation of locoregional therapies and resectional surgery to manage the case load. The introduction of biological therapies has had a new dimension to care, adding to the complexities of multidisciplinary team working in the management of HCC. The aim of this paper is to give a brief overview of present day management strategies and decision making.