Figure 2. . Hurdles in hepatocellular carcinoma treatment classified as level 1, level 2 and level 3.

Level 1 includes hurdles encountered at screening and diagnosis which involves asymptomatic disease, poor awareness of patient, lack of resources, as in case of low middle income countries, and patient's inability to pay for the tests. Educational hurdles include both poor patient's education and insufficient knowledge of healthcare provider. Level 2 includes treatment decision and acceptance of the treatment strategies and involves picking right treatment strategy based on the stage and liver function status. Level 3 includes hurdles in hepatocellular carcinoma (HCC) treatment at molecular level which holds potential to investigate various molecular changes observed in HCC patients. All these hurdles show the way to several prospects for HCC treatment which include prophylactic measures, xenotransplantion with pig liver, cell therapies and targeting awry molecules/pathways. The dotted lines in the flowchart depicts correlated aspects of hurdles and prospects.

BAL: Bio-artificial liver; HCC: Hepatocellular carcinoma; PHT: Primary hepatocyte transplantation; RAAS: Renin–angiotensin–aldosterone system.