Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the sixth most common cancer of men and e leventh most common cancer of women world-wide. However, because almost eve ry individual who develops liver cancer dies of the disease, HCC is the thi rd most common cause of the cancer deaths in men and seventh most common in women. The treatment of choice for hepatocellular carcinoma remains surgic al resection or liver transplantation, in carefully selected cases. In pati ents with hepatocellular carcinoma not amenable to surgical intervention a variety of different therapeutic interventions have been investigated. Thes e include direct ablation of the tumour using agents such as ethanol or ace tic acid, transcatheter arterial chemoembolization, or systemic chemotherap y. The evaluation of their efficacy is compromised by the paucity of adequa tely powered randomised clinical trials. The main challenge facing the rese arch community over the next decade is to prioritise the most promising tre atments and take these forward into multicentre controlled trials. Even if these fail to improve results, they will help reduce the variation in clini cal practice by eliminating anecdotal treatment.