Improvements in diagnostic techniques have enhanced our understanding of th
e natural history of hepatocellular carcinoma (HCC). This has facilitated a
proper evaluation of the available treatment options for this neoplasm thr
ough both phase II studies and randomized controlled trials. Surgical resec
tion and liver transplantation constitute the first two radical options, an
d when they are contra-indicated, patients may benefit from percutaneous et
hanol injection or thermal ablation by radiofrequency current. These option
s may also achieve a complete response and constitute the last potentially
radical therapies for small HCC. In contrast, for large multinodular tumour
s, the available treatment options have not been shown to improve survival.
Arterial embolization with or without associated chemotherapy has been wid
ely used. However, randomized controlled trials have failed to show a survi
val benefit, emphasizing the need to develop new treatment strategies.