[Surgical treatment of hepatocellular carcinoma]

Surgical treatment of hepatocellular carcinoma. The therapy of hepatocellular carcinoma (HCC) has got nowadays an important problem of medicine. The five year survival time has increased in the consequences of the last 25 year medical activities. The development of liver surgery, the introduction of aggressive surgical strategy, the prognosis of the disease and the special indication of the operation have had important factors in bettering of the results. The size and number of the tumor, the tumor-free region of the tissue resected, capsule building, and the venous infiltration are the most important factors influencing the survival time. The repeated resection in case of newly developed HCC has got also a result with 19-20 per cent of five year survival time. In cases of non resectable tumors the a la carte chemotherapy, radiofrequency, TACE for down staging produce an opportunity in 10-20% of tumors being resectable. The new combined surgical-oncologic-intervention strategies involve the two step and repeated interventions, the minimal invasive technique (MIT), the TACE and the a la carte chemotherapy. Liver transplantation can be carried out exclusively in tumors less than 3 cm and in those having no more than 3 metastases.