Related Experiment Video
Updated: Nov 29, 2025
Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Surgical treatment of hepatocellular carcinoma
Insights
Surgical options for hepatocellular carcinoma (HCC) include liver resection or transplantation, but only 30% of patients are eligible. Early-stage HCC offers 60-80% five-year survival with surgical treatment.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) treatment is multimodal, with surgery (liver resection or transplantation) being a key component.
- Only 30% of HCC patients are initially eligible for surgical intervention.
- Surgical candidacy depends on patient condition, disease extent, liver function, and future liver remnant volume.
Purpose of the Study:
- To outline the surgical treatment modalities for hepatocellular carcinoma (HCC).
- To discuss patient selection criteria for liver resection and transplantation.
- To review alternative palliative treatments for unresectable HCC.
Main Methods:
- Anatomical liver resections are preferred for HCC.
- Staged procedures can enhance resectability in cases of insufficient liver volume.
- Liver transplantation adheres to Milan criteria, addressing both HCC and underlying liver disease (cirrhosis).
Main Results:
- Early-stage HCC detected surgically offers a five-year survival rate of 60-80%.
- Palliative options like thermoablation, transarterial chemoembolization (TCE), or radioembolization (RE) are available for unresectable cases.
- Neoadjuvant embolization can facilitate subsequent liver resection or transplantation in select patients.
Conclusions:
- Surgical treatment, including resection and transplantation, is crucial for eligible HCC patients.
- Patient selection and surgical technique are critical for successful outcomes.
- Palliative therapies and neoadjuvant treatments offer management options when primary surgery is not feasible.
Abstract:
Surgical treatment of hepatocellular carcinoma (HCC) is part of multimodal treatment and consists of liver resection or transplantation. Unfortunately, only 30% of patients with HCC are primarily surgically treatable. The indication for surgery is based on the patients bio-logical condition, the extent of the disease, the function of the liver parenchyma and the residual volume of the liver. For liver resections, we choose anatomical resections. In case of insufficient residual volume of the liver, we have a possibility of staged procedures to increase the resectability of HCC. Liver transplantation solves not only the HCC itself, but also advanced underlying liver disease (cirrhosis) and is based primarily on the Milan indication criteria. The long-term results of surgical treatment depend on the progress of HCC. In HCC detected in the initial stage, the five-year survival of patients is 60-80%. In patients in whom radical resection or transplantation of the liver cannot be performed for various reasons, palliative methods, today mainly thermoablation, or transarterial chemoembolization or radioembolization are possible. In some patients, liver resection or transplantation can be performed after embolization.
