Non-surgical therapies of hepatocellular carcinoma

Early detection of hepatocellular carcinoma (HCC) through surveillance programmes allows potentially curative therapies such as resection, liver transplantation and percutaneous ablation to be applied in 40% of the patients. In non-surgical candidates, percutaneous treatments are the best therapeutic approach, and may improve survival in patients with well preserved liver function and small tumours that achieve initial complete response. Applying these criteria 5-year survival rates above 50% are achieved. Radio frequency thermal ablation provides slightly better objective response rates than ethanol injection, but no survival advantages have been reported. At more advanced stages, only chemoembolization has been shown to improve survival in well-selected candidates.