Hepatocellular Carcinoma With Portal Venous Invasion

The growing incidence of hepatocellular carcinoma (HCC) is a major global public health challenge. The mortality rate for HCC is very high, and most available treatment options remain palliative. Early-stage HCC can be treated with curative intent with transplantation, resection, or ablation. Level 1 evidence from randomized clinical trials has demonstrated a survival advantage for transarterial chemoembolization (TACE) vs supportive care for intermediate-stage HCC and for systemic therapy with sorafenib, lenvatinib, regorafenib, and cabozantinib for advanced-stage HCC. Recently, immune checkpoint inhibitors have demonstrated impressive antitumor activity with high response rates in advanced HCC, and phase 3 trials are ongoing to assess survival benefits.

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