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World J Gastroenterol. Nov 28, 2014; 20(44): 16630-16638
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16630
Advances in non-surgical management of primary liver cancer
Xiao Chen, Hai-Peng Liu, Mei Li, Liang Qiao
Xiao Chen, Hai-Peng Liu, Mei Li, Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Xiao Chen, Hai-Peng Liu, Mei Li, Key Laboratory of Digestive System Tumors of Gansu Province, Lanzhou 730030, Gansu Province, China
Liang Qiao, Storr Liver Unit, Westmead Millennium Institute, Department of Medicine and Western Clinical School, University of Sydney, NSW 2145, Australia
Author contributions: Chen X contributed to the conception, design, and creation of the first draft; Liu HP and Li M assisted with manuscript writing, the reference search, and table generation; Qiao L made considerable language edits and revisions to the manuscript, and approved the final version for publication.
Correspondence to: Liang Qiao, MD, PhD, Storr Liver Unit, Westmead Millennium Institute, Department of Medicine and Western Clinical School, University of Sydney, Westmead, NSW 2145, Australia. liang.qiao@sydney.edu.au
Telephone: +61-2-86273534
Received: May 9, 2014
Revised: June 17, 2014
Accepted: July 22, 2014
Published online: November 28, 2014
Processing time: 207 Days and 0.1 Hours
Abstract

Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third most common cause of cancer-related death worldwide. There have been great improvements in the diagnosis and treatment of HCC in recent years, but the problems, including difficult diagnosis at early stage, quick progression, and poor prognosis remain unsolved. Surgical resection is the mainstay of the treatment for HCC. However, 70%-80% of HCC patients are diagnosed at an advanced stage when most are ineligible for potentially curative therapies such as surgical resection and liver transplantation. In recent years, non-surgical management for unrespectable HCC, such as percutaneous ethanol injection, percutaneous microwave coagulation therapy, percutaneous radiofrequency ablation, transcatheter arterial chemoembolization, radiotherapy, chemotherapy, biotherapy, and hormonal therapy have been developed. These therapeutic options, either alone or in combination, have been shown to control tumor growth, prolong survival time, and improve quality of life to some extent. This review covers the current status and progress of non-surgical management for HCC.

Keywords: Ablation therapy; Biotherapy; Hepatocellular carcinoma; Hormonal therapy; Percutaneous ethanol injection; Percutaneous microwave coagulation therapy; Radiofrequency ablation; Radiotherapy; Transcatheter arterial chemoembolization; Chemotherapy

Core tip: In recent years, there has been considerable progress in the development of non-surgical management for unrespectable hepatocellular carcinoma. These therapeutic options, either alone or in combination, have been shown to control tumor growth, prolong patient survival, and improve quality of life to some extent. Some of these strategies have been extensively used in clinical practice as the preferred approaches for advanced primary liver cancer.