Surgical Considerations for Primary Liver Neoplasms

Primary liver neoplasms, primarily hepatocellular carcinoma and intrahepatic cholangiocarcinoma, remain a major global health burden with poor survival and limited systemic therapy options. Determining resectability requires comprehensive preoperative assessment, including high-quality imaging, liver function evaluation, and future liver remnant volume calculations. Surgical resection with negative margins offers the best chance for long-term survival, and minimally invasive approaches are increasingly used in selected patients. For those with advanced but potentially resectable disease, strategies such as neoadjuvant chemotherapy, portal vein embolization, radiation lobectomy, and hepatic artery infusion chemotherapy provide opportunities for downstaging and potential resection.