Recent studies suggest that for optimum clinical outcomes, management of hepatocellular carcinoma necessitates the most reliable classification of tumors, including histopathologic evaluation. Dr. Brunt discusses current criteria, useful immunohistochemistry stains, and differential diagnostic considerations for hepatocellular carcinoma.

Dr. Cabrera discusses the planned, ongoing, and

completed clinical trials for advanced HCC. A brief overview of recent failures and ongoing clinical studies with emerging molecular targeted agents along with future perspectives is covered.

Drs. Chaiteerakij and Roberts summarize the current understanding of the pathogenesis of hepatocellular carcinoma and HCC tumor biology gained from recent studies using NGS technology to analyze HCC tumors. They also discuss potential strategies for harnessing this new information to improve therapy for patients with advanced HCC.

The Barcelona Clinic Liver Cancer (BCLC) staging system was designed to stratify patients according to outcome while simultaneously linking it with treatment indication. Drs. Forner, Rodriguez-Lopez, and Reig highlight the advantages to the BCLC staging system, while also addressing areas for further refinement.

Hepatocellular carcinoma is the third most common cause of cancer-related deaths worldwide, and each year, approximately 750,000 new cases are diagnosed. As the incidence of liver cancer continues to rise, effective surveillance programs are necessary in order to maximize patient outcomes which require effective identification of HCC risk factors.

Hepatocellular carcinoma is the most rapidly increasing cause of cancer mortality with poor prognosis in the United States. Molecular biomarkers are emerging as a way to enable effective, personalized patient management with limited medical resources. Dr. Hoshida reviews molecular risk factors of HCC development, molecular subclasses of aggressive HCC tumor, and the need for clinical translation of molecular indicators of HCC risk.

Drs. Liapi and Geschwind present an overview of some novel local therapies for unresectable hepatocellular carcinoma that have been introduced recently to the medical community or are currently under preclinical and initial clinical testing.

Prognosis for patients with hepatocellular carcinoma depends on tumor stage at diagnosis, with curative options only available for patients diagnosed at an early stage. Drs. Rahimi, Yopp, and Singal review the best available evidence supporting HCC surveillance and discuss future trends in surveillance.

In many circumstances, the specificity of imaging characteristics may be sufficient to establish a diagnosis of hepatocellular carcinoma. Drs. Russo and Wald review when imaging alone is adequate for diagnosing HCC and when biopsy is needed.

The use of laparoscopic techniques in the treatment of cancer has grown in acceptance over the last decade, as the initial concerns of comprising oncological principles and port-site metastases in laparoscopic resections have largely proven unfounded. However, the use of laparoscopic techniques in liver resection for hepatocellular carcinoma has not been fully embraced.