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Current Trends and Future Challenges in Hepatocellular Carcinoma

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Dear Colleagues,

Liver cancer is the third leading cause of all the cancer-related deaths in the world, and its incidence continues to rise. Hepatocellular carcinoma (HCC) represents ~80% of all the liver cancer cases. Major drivers of HCC include chronic liver disease (CLD) caused by metabolic dysfunction-associated steatotic liver disease (MASLD), viruses (HBV, HCV), and alcohol consumption. Despite the plethora of different etiological factors driving CLD, critical stages such as steatohepatitis, fibrosis, and cirrhosis are commonly observed in each and underlie HCC development.

Mechanistic studies and the development of different high-throughput technologies along with advancements in bioinformatic analyses have started unravelling the key molecular drivers of hepatocarcinogenesis development and progression. Collectively, these studies have not only underscored the need for further investigations to fully understand the complexities underlying HCC but also ways and means to discover new therapeutic targets and biomarkers to improve patient’s outcomes and reduce the socioeconomic burden.

This Special Issue focuses on “Current Trends and Future Challenges in Hepatocellular Carcinoma”. The main objectives are to explore the various mechanisms driving HCC development of various etiologies, discovering novel ways for their early diagnosis and revealing new avenues of treatment. The issue will also include personalized medicine and its impact on HCC prevention and management.

This Special Issue welcomes the submission of original research and review articles focusing on cellular, molecular, bioinformatic, epidemiological, and clinical aspects of the development of HCC, the prognosis, and its prevention. This Special Issue will enlighten researchers and clinicians about new discoveries, advances, and development in the field of HCC.

Dr. Atish Mukherji
Guest Editor

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12 pages, 1901 KB

Open AccessArticle

Hepatic Arterial Infusion Chemotherapy in the Treatment of Unresectable Hepatocellular Carcinoma with and Without Extrahepatic Spread: A Propensity Score Matching Study

by Chao-Ting Chen, Huei-Lung Liang, Chia-Ling Chiang, Wei-Lun Tsai and Yu-Chia Chen

J. Pers. Med. 2025, 15(11), 561; https://doi.org/10.3390/jpm15110561 - 19 Nov 2025

Viewed by 765

Abstract

Purpose: We aimed to study the efficacy and safety of hepatic artery infusion chemotherapy (HAIC) in the treatment of unresectable hepatocellular carcinoma (HCC) with extrahepatic spread (EHS). Materials and Methods: A total of 323 patients with unresectable HCC received HAIC plus lipiodol microvascular embolization. HAIC was performed via puncture of the left subclavian artery with a temporary 4-French angio-catheter placed in the common/proper hepatic artery. The HAIC regimen consisted of a daily infusion of cisplatin (10 mg/m²), mitomycin-C (2 mg/m²), and leucovorin (15 mg/m²), administered over a period of 20–30 min, and then a 5-fluorouracil (5-FU, 100 mg/m²) infusion for the remaining of 22 h of each day, for five consecutive days. Before the temporary catheter was removed, 10 mL of ethiodized oil (Lipiodol, Guerbet, France) was injected to obtain a synergistic effect of chemoinfusion and lipiodol microvascular embolization. Treatment responses were evaluated based on mRECIST criteria. The objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) of patients with EHS were compared to those without. Subgroup analyses of patients with and without major portal vein tumor thrombosis (PVTT) were performed both before and after propensity score matching (PSM). The survival analyses were conducted with the Kaplan–Meier method and compared using the log-rank test. All the statistical analyses were performed by SPSS (version 26.0). Result: The overall ORR was 59.1%. The median OS of the initial cohort and patients positive and negative for EHS were 16.3, 12.0, and 18.0 months, respectively (p = 0.002). In the subgroup analysis, there was no statistical difference in survival in patients with major PVTT between the with-EHS and without-EHS groups (13.0 vs. 15.0 months, p = 0.407). However, the median OS in patients with EHS was significantly shorter than those without EHS (11.4 vs. 19.4 months, p < 0.001) in the subgroup of non-major PVTT patients. After PSM, there were no significant survival differences between the EHS and non-EHS groups in any patient cohort or sub-cohort analysis. Conclusions: For unresectable HCC, controlling intrahepatic tumor progression through HAIC is more important than controlling extrahepatic tumor growth, especially in patients with major PVTT. Personalized locoregional HAIC can be performed in patients with EHS. Full article

(This article belongs to the Special Issue Current Trends and Future Challenges in Hepatocellular Carcinoma)

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