Primary liver cancer is the fifth most common cancer worldwide and the third most common cause of death from cancer, resulting in more than 600,000 deaths per year. The major risk factors for hepatocellular carcinoma are chronic hepatitis B or hepatitis C virus infection, alcoholic cirrhosis, and nonalcoholic steatohepatitis.¹ Cancer probably develops in the cirrhotic liver through the induction of accelerated cycles of cell injury, death, and regeneration in an altered fibrotic and inflammatory microenvironment. Abnormal immortalized cell clones arise, and these cells develop genetic and epigenetic alterations that provide a survival and proliferative advantage, resulting in unconstrained proliferation, a . . .