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Single HCC between 2 and 5 cm: the grey zone: surgeon's perspective
Kiyoshi Hasegawa1, Norihiro Kokudo, Keiji Sano
1Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Journal of Hepato-Biliary-Pancreatic Sciences
|November 6, 2009
Summary
For single hepatocellular carcinoma (HCC) tumors between 2-5 cm, liver resection is preferred over ablation. Liver transplantation is an option for patients with poor liver function, considering age.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) management requires controlling the tumor, vascular invasion, and intrahepatic metastases.
- Treatment decisions for HCC depend on tumor size, vascular invasion, and liver function.
Purpose of the Study:
- To compare the efficacy of liver resection versus percutaneous ablation for single HCCs between 2 and 5 cm.
- To establish the first-choice therapeutic option for resectable HCC based on tumor characteristics and liver function.
Main Methods:
- Review of indirect evidence comparing liver resection and percutaneous ablation for HCC.
- Analysis of factors influencing treatment choice, including tumor size, vascular invasion, and liver functional reserve.
Main Results:
- Liver resection appears advantageous over percutaneous ablation for single HCCs measuring 2-5 cm in diameter.
- Resection is the preferred option when liver function is adequate.
Conclusions:
- Liver resection is the primary therapeutic choice for eligible HCC patients.
- Liver transplantation is a viable alternative for patients with poor liver reserve, contingent on age.
