Surgical resection of localized hepatocellular carcinoma: patient selection and special consideration

Abstract

Localized hepatocellular carcinoma (HCC) refers to a solitary or few tumors located within either the left or right hemiliver without evidence of bilobar or extrahepatic spread. This term encompasses a heterogeneous morphology with no regard to stage of prognosis of the disease. Surgical resection remains the mainstay of curative treatment for the localized HCC. Various biochemical and radiological tests constitute an indispensible part of preoperative assessment. Emergence of laparoscopic hepatectomy has brought liver resection into a new era. Improved understanding of the pathophysiology of HCC allows more aggressive surgical resection without compromising outcomes. New insights into the management of special situations, such as ruptured HCC, pyogenic transformation of HCC, and HCC with portal vein tumor thrombus, rekindle the hopes of curative resection in these terminal events. Amalgamating salvage liver transplantation into the surgical management of resectable HCC has revolutionized the treatment paradigm of this deadly disease.

Clinical features of hepatocellular carcinoma with hepatitis B virus among patients on Nucleos(t) ide analog therapy

“…Liver resection remains the main curative option for HCC [29]. However, TACE is the most widely utilized and is considered the first-line treatment for patients [30].…”

Impact of tenofovir antiviral treatment on survival of chronic hepatitis B related hepatocellular carcinoma after hepatectomy in Chinese individuals from Qingdao municipality

“…Surgical resection is regarded as the main curative therapy for HCC. [ 15 – 18 ] Previous studies have revealed that sustained HBV replication is strongly associated with HCC recurrence in CHB-related HCC patients after surgery. [ 19 ] Recent studies have confirmed that NAs can decrease the recurrence rate in CHB-related HCC patients receiving hepatic resection.…”

Impacto do escore MELD na sobrevida de pacientes portadores de carcinoma hepatocelular, transplantados no Brasil: revisão sistemática.

“…H epatocellular carcinoma (HCC) is responsible for over 90% of primary hepatic malignancies and considered the sixth most commonly diagnosed malignant disease in the world 1 . Due to its late diagnosis, the average patient survival ranges approximately from six to 20 months, with a fiveyear survival inferior than 12% 2 .…”