Locoregional therapy in hepatocellular carcinoma: when to start and when to stop and when to revisit

With increasing therapeutic options available for advanced hepatocellular carcinoma (HCC), the timing and sequencing of locoregional and systemic therapy need to be re-examined. This is especially so for patients with intermediate HCC, so as to optimize responses while preserving liver reserves, and in so allowing our patients to achieve the best survival outcomes possible. •More systemic therapy options for advanced HCC are available.•The traditional linear mindset of transiting to systemic therapy on exhausting locoregional options deserves re-examination.•Multidisciplinary discussion is essential in sequencing options to optimize response while preserving liver function.