The Role of Natural Products in Liver Cancer: Focus on Angiogenesis, Inflammation, Oxidative Stress, and Apoptosis

Hepatocellular carcinoma (HCC) is the primary liver tumor that arises from various risk factors, including hepatitis, excessive alcohol consumption, and obesity. These risk factors induce pathophysiological alterations in the liver, such as inflammation, fibrosis, cirrhosis, fatty liver, abnormal regeneration, and angiogenesis. Although procedures like ablation and transplantation hold promise for addressing this malignancy, the recurrence and metastasis rates limit the long-term efficacy of these surgical interventions. Thus, natural compounds exhibit great potential in enhancing clinical interventions, managing the disease effectively, and improving survival rates in HCC. Compounds such as silymarin, silibinin, resveratrol, curcumin, quercetin, genistein, naringenin, cucurbitacin, lycopene, crocin, aronia, Nigella sativa, epigallocatechin-3-gallate, and ginger (Zingiber officinale) demonstrate promise in HCC treatment, primarily through mechanisms involving the suppression of inflammation, regulation of oxidative stress, and promotion of apoptosis. This study searched PubMed, Scopus, Web of Science, Google Scholar, and ClinicalTrials.gov databases to evaluate the molecular mechanisms by which natural compounds are associated with HCC. The literature search was performed using the keywords "hepatocellular carcinoma," "angiogenesis," "inflammation," "oxidative stress," "natural products," and "apoptosis." By evaluating the findings cumulatively, the aim was to reveal the up-to-date scientific evidence for using natural compounds as potential therapeutic agents in treating HCC.