Surgical management of hepatocellular carcinoma — Western versus eastern attitude

Hepatocellular carcinoma (HCC) is the most common liver tumour and represents a significant health burden. The different characteristics of the disease in the various parts of the world, as much as economic and social features, explain only partially the great diversity in the treatment options offered to patients in different countries. The most apparent contrast in term of tumour management is between the western and eastern world. Striking differences involve not only the attitude towards indications for liver transplantation or liver resection but also the surgical techniques adopted. Although remarkable signs of progress have been achieved in surgical and pharmacological fields, univocal guidelines are yet lacking, preventing effective comparisons between retrospective studies and clinical trials. This review aims to analyse and compare some of the most relevant and essential traits of the eastern and western therapeutic strategy against HCC.