Resection and transplantation for hepatocellular carcinoma: Factors influencing surgical options

Rebecca M. Dodson, Jin He, Timothy M. Pawlik

Research output: Contribution to journalReview articlepeer-review

Abstract

The management of hepatocellular carcinoma within the Milan criteria and with well-compensated cirrhosis is a topic of debate. Recent surveillance programs in patients with hepatitis C and cirrhosis have allowed some patients to be diagnosed with early, potentially curable, disease via liver resection (LR), liver transplantation (LT) or liver ablation. LT has excellent outcomes with 5-year survival rates >70% for patients within the Milan criteria. However, its utilization is limited by increasing organ shortages. LR is also effective with 5-year survival outcomes between 50-70% and safe in light of advances in surgical technique, preresection optimization and patient selection. Patients with solitary tumors and well-preserved liver function are good candidates for LR, whereas LT is best reserved for patients with compromised liver function and multifocal disease. LT and LR should not be viewed as competing tools but as complementary tools in the current armamentarium to treat early hepatocellular carcinoma.

Original languageEnglish (US)
Pages (from-to)587-607
Number of pages21
JournalFuture Oncology
Volume10
Issue number4
DOIs
StatePublished - Mar 2014

Keywords

  • HCC
  • cancer
  • early stage
  • hepatocellular carcinoma
  • liver
  • resection
  • surgery
  • transplantation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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