Which of the following statement(s) is/are true concerning the treatment and prognosis of hepatocellular carcinoma?

a.The fibrolamellar variant of hepatocellular carcinoma has a distinctly better prognosis than other forms of the disease

b.Patients with untreated hepatocellular carcinoma rarely survive a year

Hepatocellular carcinoma has a tendency for local and vascular invasion. Untreated, patients have a dismal prognosis with a median survival of only three to four months after diagnosis with only rare survival beyond one year. The fibrolamellar variant of hepatocellular carcinoma has a distinctly better prognosis with a five year survival after resection of 50% to 60% versus 25% for other varieties. Surgical resection offers the only chance for cure for primary hepatic malignancy, and survival is better if tumors are small and asymptomatic. The role of orthotopic liver transplantation for hepatocellular carcinoma continues to evolve. For patients with severe hepatic dysfunction or larger or centrally located tumors or bilobar tumors, this may be the preferred approach. Extrahepatic disease including lymph node involvement is a contraindication to resection or transplantation. No single-or multiple-agent chemotherapy is particularly effective in treating hepatocellular carcinoma. The rationale for treating vascular liver tumors with arterial obstruction is the fact that the nutritional blood supply of these tumors comes primarily from the hepatic artery. Hepatic artery ligation or embolization alone or in combination with regional chemotherapy has been shown to be ineffective for liver cancer. In addition, hepatic artery ligation has a high complication rate and cannot often be used in patients with compromised liver function from cirrhosis.