Evaluating the current surgical strategies for hepatocellular carcinoma

Expert Rev Gastroenterol Hepatol. 2016;10(3):341-57. doi: 10.1586/17474124.2016.1116381. Epub 2015 Dec 10.

Abstract

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. Despite careful surveillance programs and the development of antiviral therapy for hepatitis virus infection, the occurrence rate of HCC remains high. Liver resection and liver transplantation are mainstay curative treatments. Most patients with HCC have impaired liver function, and surgical treatment is always accompanied by the risk of decompensation of the remnant liver, especially when the volume of the remnant liver is too small and the liver function too low to meet metabolic demands. The mortality of liver resection has dramatically decreased over the last three decades from 20% to less than 5% due to the accumulation of knowledge of liver anatomy, perioperative management and preoperative assessment of liver function. Here we provide an overview of the multidisciplinary treatments and current standard treatment strategies for HCC, to explore the possibility of expanding surgical treatments beyond the current standards.

Keywords: Hepatocellular carcinoma; anatomical liver resection; liver resection.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / mortality
  • Hepatectomy* / adverse effects
  • Hepatectomy* / mortality
  • Humans
  • Liver Function Tests
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Liver Regeneration
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / mortality
  • Neoplasm Staging
  • Risk Factors
  • Treatment Outcome