Hepatocellular carcinoma: a comprehensive overview of surgical therapy

J Surg Oncol. 2014 Nov;110(6):712-9. doi: 10.1002/jso.23673. Epub 2014 Jun 4.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, with a rising incidence in the United States. The increase in medical and locally ablative therapies have improved prognosis, however surgery, either liver resection or transplantation, remains the mainstay of therapy. An increased understanding of liver anatomy, improved imaging modalities and refinements of surgical technique have all led to improved outcomes after surgery. Both resection and transplantation may be used in a complementary manner. Resection remains the treatment of choice for HCC when feasible. Liver transplantation, which removes both the tumor and the underlying diseased liver offers excellent outcomes in patients that meet the Milan criteria. While both these modalities have relatively well defined roles, the treatment of these patients must be tailored individually, using a multidisciplinary approach, to maximize survival, quality of life and allocation of scarce organs.

Keywords: hepatocellular carcinoma; liver resection in carcinoma; liver transplantation.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Decision Making
  • Hepatectomy
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Liver Transplantation
  • Neoplasm Staging
  • Patient Selection
  • Risk Assessment
  • Severity of Illness Index