**7. Conclusions**

Management of HCC continues to be improved due to development of newer therapies which are combined with liver resection and liver transplantation. These therapies become better tolerated and more precise even in patients with advanced liver disease. Better surveillance of cirrhotic patients allowed an early detection of HCC and permitted treatments to have a higher rate of cure. For the patients who present with HCC and moderate to severe liver insufficiency, liver transplant remains a critical method to eliminate the cancer and cure the underlying liver disease with a lower risk of recurrence than resection or ablation. The best results for liver resection are obtained in patients with small solitary tumors, but there is a high rate of disease recurrence due to cell dissemination prior to treatment. Improved survival for patients treated with Sorafenib for advanced disease increases enthusiasm for additional therapies for HCC.

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Nowadays, the improvement of the surveillance will allow detection of the early stage of HCC when the loco-regional treatment is effective and transplantation is reserved only for selected cases. Alfa-fetoprotein and ultrasound scan should be used every 6 months for surveillance in high-risk individuals.
