Primary liver cancer is one of the three major major fatal diseases in China at present. After years of exploration, a more scientific treatment plan has been formed for its treatment, and in 2012, the Ministry of Health of China issued the “Treatment Standard for Primary Liver Cancer” for liver cancer treatment. However, the current status of liver cancer treatment is rather confusing. Due to the influence of many factors and the different medical standards of different hospitals, often the same patient with liver cancer is seen in different hospitals or by different doctors in the same hospital, but receives very different treatment plans, and patients are at a loss as to who is right and who is wrong. Choosing the right treatment for a patient is a test of a doctor’s overall ability and quality. In view of this situation, I would like to discuss my views on the treatment of liver cancer with the “treatment standard” issued by the Ministry of Health and some of my clinical experiences. I. The treatment of early and mid-stage liver cancer is recognized as the first choice of surgical treatment at home and abroad. Surgical treatment for liver cancer mainly includes the following three choices: ①, liver resection; ②, liver transplantation; ③, radiofrequency treatment for liver cancer. For early to mid-stage liver cancer combined with moderate to severe cirrhosis, liver transplantation is the first choice, followed by radiofrequency treatment. Since patients with moderate to severe cirrhosis cannot withstand the trauma of liver resection and will suffer from complications of liver failure such as jaundice and ascites after surgery, which may even lead to death, these patients are not suitable for liver resection. The implementation of liver transplantation is not limited by the patient’s poor liver function. Liver transplantation not only removes the tumor to the maximum extent, but also removes the soil of recurrence of liver cancer (cirrhosis), eliminates the risk of bleeding from ruptured esophageal vein due to portal hypertension, restores normal liver function, and provides favorable conditions for further treatment of liver cancer. Therefore, liver transplantation is the first choice of treatment because of its “multi-functional” effect. After decades of development, liver transplantation has become mature in China and has reached the advanced level in foreign countries. The 10-year survival rate after liver transplantation for benign liver disease has reached over 70%, which is the best efficacy among all large organ transplants. Since the first liver transplantation in April 2003, our department has completed more than 300 liver transplants for liver cancer, and the longest survival has been more than 11 years, with good survival status and an overall 5-year survival rate of 82% for liver cancer, which is among the most advanced in China. However, liver transplantation also has “bottleneck” problems. First of all, the source of liver donor is extremely collapsed, and there are many patients, about 89 million “hepatitis B” carriers in China, and about 300,000 new cases of liver cancer every year, accounting for more than 50% of the world. Incomplete statistics show that the “donor-recipient” ratio for organ transplantation in China is 1:150, much lower than the 1:5 ratio in developed countries, so it is purely “luck” whether patients who need to receive liver transplantation can wait for a liver source. Secondly, the cost of liver transplantation is relatively high, although liver transplantation has entered the scope of “medical insurance” reimbursement, but still a large part of the cost needs to be borne by the individual, not every family can afford. In addition, liver transplantation is a large and traumatic operation, and the risk of surgery is relatively high compared to ordinary hepatobiliary surgery, which is not something that every potential liver transplant patient’s family is willing to accept. Although all domestic hospitals with liver transplantation qualifications can perform liver transplantation, the level of each liver transplantation center is still “uneven”, and the technical level of the liver transplantation center has a certain impact on the long-term survival rate after transplantation. For patients with early to mid-stage liver cancer who are not eligible for liver transplantation, but have moderate to severe cirrhosis, radiofrequency therapy is a good option. Radiofrequency treatment is mainly applicable to tumors below 8 cm in diameter, and for some patients with tumors between 3 and 5 cm, the treatment effect can reach similar effect of surgical resection. Radiofrequency is essentially a kind of physical therapy, which is inserted into the tumor through a specially designed radiofrequency needle via penetration, which is converted into high temperature after conducting electricity and kills the tumor through high temperature. There are various methods of radiofrequency penetration, which can be guided by B-ultrasound, CT, open abdomen or laparoscopic guidance, and the specific method of guidance should be determined by experienced physicians depending on the size and location of the tumor. Radiofrequency has the characteristics of minimally invasive, fast recovery after surgery, low risk and low cost, especially suitable for small liver cancer patients with moderate to severe cirrhosis. Since 1999 (the earliest introduction in East China), our department has applied this device to treat liver cancer, and has completed nearly 3,000 cases so far, with the longest survival reaching more than 10 years. However, radiofrequency treatment also has certain limitations. For tumors with diameter above 5 cm or close to large blood vessels and hepatic hilum, the effect of radiofrequency treatment is often not so satisfactory because sometimes there may be missed, or because the heat close to large blood vessels is often carried away by blood, so the local temperature cannot reach the level of killing the tumor, and the tumor located in the first hepatic hilum may even accidentally injure the biliary tract and cause biliary complications. Therefore, for this group of tumor patients, other methods such as TACE should be used in combination with the treatment. For early to mid-stage liver cancer with mild cirrhosis or without cirrhosis, surgical resection is the first choice. Compared with liver transplantation, liver resection has the characteristics of low cost, low risk and fast recovery, which are widely used in China. In recent years, with the advancement of liver transplantation, especially in vivo liver transplantation, some fine techniques applied in in vivo liver transplantation have been widely used in liver resection, such as ICG determination of liver reserve function, precise liver volume determination, CUSA knife and intraoperative ultrasound application (all of the above equipment are available in our hospital), which has promoted the gradual transformation of liver resection from the traditional rough large liver resection to precise liver resection. The application of precision hepatectomy has made patients undergoing hepatectomy suffer less trauma, less complications and faster postoperative recovery, and more importantly, some hepatocellular carcinoma that cannot be resected by traditional methods can be resected. Since 2008, our department has applied precision hepatectomy in clinical practice, and now there are more than 200 cases of hepatic tumors resected by precision hepatectomy every year, many of which were transferred to our hospital from outside hospitals due to inoperable resection, which also marks the advanced level of liver surgery in our hospital. Of course, there are certain shortcomings of hepatectomy: ①, hepatectomy is a local treatment, which has no therapeutic effect on combined hepatitis and cirrhosis and life-threatening portal hypertension. Of course, liver transplantation can be used to treat some liver cancers that are located in special areas and cannot be completely resected. After surgical treatment, early and mid-stage liver cancer can be treated with TACE, systemic chemotherapy, molecular targeting, Chinese herbal medicine and radiotherapy, depending on the condition, to further consolidate the therapeutic effect. Second, for advanced liver cancer that cannot receive surgical treatment, conservative treatment is still the main clinical treatment. If the liver function of liver cancer patients is still normal, TACE or combined with molecular targeted drugs (sorafenib) can be used for treatment. Clinical cases have confirmed that some patients with hepatocellular carcinoma have obvious effect after treatment, which can greatly prolong the survival of patients. Some patients with hepatocellular carcinoma have significantly reduced the size of their tumors after the above treatments and have the opportunity of “second-stage surgical resection”. Some other patients have also achieved certain therapeutic effects after systemic chemotherapy or radiotherapy, which deserve clinical attention. For liver cancer patients with liver failure combined with jaundice and ascites, any treatment cannot prolong the survival time of the patients, and may even have the opposite effect, so symptomatic treatment should be given to these patients to reduce their symptoms. In conclusion, although liver cancer has the title of “king of cancers”, there are still more clinical treatments for liver cancer detected early and the treatment effect is more ideal. The key to improve the overall treatment effect of liver cancer lies in the screening and medical examination for people with high risk of liver cancer, early detection of early liver cancer, and selection of correct treatment for liver cancer.