First-Line Treatment Options for Primary Liver Cancer

The most recommended approach for treating primary liver cancer is surgical intervention, which includes liver resection and liver transplantation. Among these, liver resection is widely regarded as the preferred and most effective method, particularly for achieving long-term survival in patients with localized disease. The main objective of liver resection is to completely remove the tumor while preserving a sufficient volume of functional liver tissue.

To determine the suitability of this procedure, a comprehensive preoperative assessment is essential. This involves evaluating both the liver's functional reserve and the tumor's characteristics. The feasibility and success of surgery depend not only on the size and number of tumors but also on critical factors such as liver function, cirrhosis stage, tumor location, presence of a tumor capsule, and the existence of vascular invasion or venous thrombus.

For patients with early-stage liver cancer and decompensated liver function, liver transplantation can be a viable and potentially curative option. It is especially beneficial for those who are not candidates for resection or local ablation therapies.

In addition to surgical methods, other treatment modalities are available. Local treatments such as ablation and transarterial chemoembolization (TACE) are commonly used for patients who are not suitable for surgery. Radiation therapy, which can be delivered externally or internally, is generally considered a palliative option.

Systemic drug therapies also play a key role, particularly for advanced cases. These include molecularly targeted agents like sorafenib, lenvatinib, and regorafenib. In some cases, antiviral medications and hepatoprotective drugs may be prescribed to manage underlying liver disease. Complementary to conventional treatments, standardized traditional Chinese medicine (TCM) can help alleviate symptoms, boost immunity, and reduce side effects associated with chemotherapy and radiation.

When integrated appropriately into a comprehensive care plan, these treatment strategies can significantly improve outcomes and quality of life for patients with primary liver cancer.