There are numerous treatment methods for primary liver cancer, mainly including surgical resection, local ablation therapy (anhydrous alcohol injection, radiofrequency, microwave, cryotherapy, ultrasound polymerization, etc.), interventional embolization chemotherapy (TACE), liver transplantation, bio-immune therapy, traditional Chinese medicine (TCM) therapy, molecular targeted therapy and systemic chemotherapy. Currently, surgical resection, liver transplantation, and radiofrequency ablation are considered to be the treatments that may cure primary liver cancer. The treatment of liver cancer, like many other solid tumors, should be based on the individual patient’s condition with a comprehensive treatment plan that focuses on curative therapies. The 5-year survival rate after surgical resection of small hepatocellular carcinoma (less than 3 cm) can reach more than 70%. Therefore, with early detection and appropriate treatment methods, liver cancer can also get better therapeutic effect. Surgical resection is the first choice of primary liver cancer patients and the treatment effect is also the best. At present, due to the rapid development of hepatobiliary surgical technology, the safety of hepatectomy has been significantly improved, and the liver is not a forbidden area for surgery for a long time. However, the vast majority of liver cancer patients are diagnosed at a late stage and have already lost the good time for surgical resection. Whether a patient is suitable for surgical resection needs to be considered from three aspects: the patient’s general condition, liver function and whether the tumor can be completely resected. Currently, only about 20% of liver cancer patients have the chance of surgical resection. Some patients with advanced stage can have their tumors shrunk by interventional chemotherapy (TACE) and get the chance of surgery. Laparoscopic technique has been widely used in hepatobiliary surgery because of its advantages of less trauma, less pain, less intraoperative bleeding, fewer postoperative complications, quicker postoperative recovery of patients, and good cosmetic effect. We routinely perform laparoscopic hepatectomy for hepatocellular carcinoma in suitable patients and achieve satisfactory results. Local ablation therapy mainly includes anhydrous alcohol injection, radiofrequency, microwave, cryotherapy, ultrasonic polymerization, etc. Among them, radiofrequency and microwave ablation are widely used in clinic due to their relatively mature technology and precise curative effect. Local ablation therapy is mainly applied to patients with tumor diameter less than 5cm, number of lesions less than 5, and patients who cannot be surgically resected due to various reasons. If the indications are strictly grasped, local ablation therapy can achieve similar results as surgery, but the local recurrence rate is higher than that of surgical resection. Currently, local ablation therapy can be performed by ultrasound or CT-guided percutaneous puncture and intraoperatively. Individual patients are unable to achieve satisfactory therapeutic effect due to the location of the tumor in the liver. Interventional embolization chemotherapy (TACE) Interventional embolization chemotherapy is commonly known as interventional chemotherapy, which is a common treatment method for middle and advanced liver cancer. Under local anesthesia, the femoral artery is punctured, a special catheter is inserted, and the catheter is inserted into the blood-supplying artery of liver cancer through the hepatic artery, and chemotherapeutic drugs and embolic agents are injected into the artery, so as to achieve the purpose of cutting off the nutritional supply of the tumor, and maximally killing the tumor cells by the highly prolonged aggregation of chemotherapeutic drugs in the tumor body. It is mainly applied to patients with primary liver cancer who cannot be surgically resected due to large tumor size, large number and other reasons, in order to achieve the purpose of relieving symptoms and prolonging survival time, which is a kind of palliative treatment. Since interventional chemotherapy adversely affects liver function, it is not advocated that patients who can be surgically resected should adopt interventional chemotherapy before operation. Patients with severe liver function impairment are also contraindications to interventional chemotherapy. In order to reduce the chance of tumor recurrence after surgical resection (the probability of recurrence is higher with other treatments), patients with high risk factors for postoperative recurrence often need 1-2 times of interventional chemotherapy after surgery to improve the overall effect of treatment. Liver transplantation Liver transplantation is commonly known as liver transplantation, which has become more and more mature in technology. Liver transplantation for liver cancer can not only remove the tumor tissue most thoroughly, but also enable the patient to have a healthy liver again, cure the complications caused by cirrhosis and minimize the possibility of recurrence of liver cancer after surgery. Although liver transplantation has great advantages in treating primary liver cancer, liver transplantation is the most complicated surgical operation, which needs to be carried out in specialized transplantation centers, and the current scarcity of liver donors is the main reason why liver transplantation cannot be the first choice of liver cancer treatment in China at present. In addition, the efficacy of liver transplantation in treating liver cancer is directly related to the stage of the tumor, and the 5-year survival rate of early liver cancer after liver transplantation can reach about 70%. However, if there are diffuse intrahepatic metastases, tumors invade large blood vessels, or extrahepatic metastases, the tumors tend to recur rapidly after liver transplantation, and the result is extremely poor, which is considered unsuitable for liver transplantation. Based on our basic national conditions at this stage, patients with primary liver cancer who have good liver function and are able to undergo surgical resection should first choose hepatectomy. For patients with early stage of liver cancer, combined with severe liver insufficiency or end stage of cirrhosis, liver transplantation should be actively considered in order to achieve better therapeutic effect. Molecular targeted drug therapy Molecular targeted drug is the hot spot of tumor treatment and the direction of future exploration. At present, sorafenib (doxorubicin) is an effective molecular targeted drug for primary liver cancer treatment, which can inhibit or block multiple molecular mechanisms of liver cancer development and metastasis. Domestic and international studies have shown that sorafenib can prolong the survival of patients with advanced liver cancer by about 3-4 months on average. Although sorafenib has certain definite effect on middle and advanced liver cancer, it still has limitations: (1) it cannot cure the tumor and has limited effect; (2) it is only effective for primary liver cancer (especially hepatocellular carcinoma); (3) it is expensive; (4) it has certain side effects, and it is not suitable to be used in patients with poor systemic condition and liver function. Therefore, sorafenib can be used in advanced liver cancer patients with good general conditions or as an effective part of comprehensive treatment for primary liver cancer. The value of bioimmunotherapy, traditional Chinese medicine and systemic chemotherapy in the treatment of primary liver cancer is still controversial, and they can only be used as auxiliary measures in the comprehensive treatment at present.