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Surgical Resection for Hepatocellular Carcinoma: When Is It the Right Choice?
Published: Oct 22, 2023
Surgical resection is a potentially curative treatment for hepatocellular carcinoma (HCC). But who are the best candidates for this procedure, and what can patients expect?
Ideal Candidates for Resection
The best candidates for surgical resection typically have a single tumor confined to the liver without vascular invasion. They should have good liver function, usually Child-Pugh class A cirrhosis, and no significant portal hypertension. However, some centers may consider resection for patients with more advanced disease, depending on their expertise and the patient's overall health.
The Resection Procedure
During a liver resection, surgeons remove the part of the liver containing the tumor, along with a margin of healthy tissue. This can be done through traditional open surgery or, in some cases, laparoscopically. The extent of the surgery depends on the tumor's size and location. The remaining liver can regenerate over time, restoring liver function.
Outcomes and Recovery
For carefully selected patients, surgical resection can offer excellent outcomes. Five-year survival rates can be as high as 70% in some cases. Recovery time varies but typically involves a hospital stay of 5-10 days. Full recovery may take several weeks to months. Patients will need regular follow-up to monitor for recurrence.
Potential Risks and Complications
As with any major surgery, liver resection carries risks. These can include bleeding, infection, liver failure, and bile leakage. The risk of complications is higher in patients with more advanced liver disease. It's crucial for patients to discuss these risks with their surgical team and understand the potential benefits and drawbacks.
Frequently Asked Questions
Typically 2-4 hours, depending on the extent of resection.
Not necessarily, but recurrence is possible.
Resection removes the tumor surgically; ablation destroys it in place.
Specialized centers with experienced teams are preferable.
It depends on individual factors; discuss with your oncologist.
Is Resection Right for You?
While surgical resection can be an excellent option for some HCC patients, it's not suitable for everyone.
References
- European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol 2018; 69:182.
- Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet 2018; 391:1301-1314.
- Torzilli G, et al. A snapshot of the effective indications and results of surgery for hepatocellular carcinoma in tertiary referral centers: is it adherent to the EASL/AASLD recommendations?: an observational study of the HCC East-West study group. Ann Surg 2013; 257:929-937.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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