Fig. 1

Trilogy of occurrence and development for HCC and current treatment A The cause of HCC is not very clear, but the main risk factor is chronic hepatitis caused by hepatitis B virus or hepatitis C virus. At the same time, due to heavy drinking and drug toxicity, could cause liver cirrhosis, ALD, NAFLD, metabolic abnormalities (such as type 2 diabetes), liver fibrosis and aflatoxin contaminated food, all of the above liver diseases may lead to HCC eventually. B Patients with a single or within 3 liver tumors, the tumor diameters less than 3 cm are classified as early cancer (stage I), also known as small HCC, and could be get better prognosis from liver resection, liver transplantation, local ablation, and radiation therapy. Patients with greater tumor, limited to the liver and Child Pugh A/B are considered to have intermediate stage cancer (stage II), which could be benefit from interventional therapy (IT) and chemotherapy. HCC patients with vascular invasion and/or extrahepatic cancer symptoms are considered to have advanced cancer (stage III) which profits by molecular targeted therapy (sorafenib), immune checkpoint inhibitors and TCM treatment based on syndrome differentiation. Patients with end-stage (stage IV) HCC usually show Child Pugh C/D or PS 3–4, so they take palliative treatment