Hepatocellular carcinoma: Current surgical management Journal Article
| Authors: | Song, T. J.; Wai Kit Ip, E.; Fong, Y. |
| Article Title: | Hepatocellular carcinoma: Current surgical management |
| Abstract: | Hepatocellular carcinoma (HCC) is the fifth most common malignancy in the world, responsible for 500,000 deaths globally every year. Although HCC is a slow-growing tumor, it is often rapidly fatal because it is usually not discovered until the disease is advanced. HCC occurs primarily in individuals with cirrhosis, a condition that increases the risk of performing potentially curative surgical therapy. Over the last 2 decades, however, the safety of surgical resections has greatly improved because of advances in radiologic assessment, patient selection, and perioperative care. As such, the operative mortality rate for hepatectomy has decreased from the 10%-20% level seen in the 1980s to less than 5% today. The ultimate goal of treatment of HCC is to prolong the quality of life by eradicating the malignancy while preserving hepatic function. For treatment with a curative intent, the gold standard remains surgical resection, by either partial hepatectomy or total hepatectomy followed by liver transplantation. Resectability and choice of procedure depend on many factors, including baseline liver function, absence of extrahepatic metastases, size of residual liver, availability of resources including liver graft, and expertise of the surgical team. Patients without cirrhosis can tolerate extensive resections, and partial hepatectomy should be considered first. For Child class B and C patients with a small HCC, liver transplantation offers the best results, whereas partial liver resection is indicated in patients with well-compensated cirrhosis. Living donor liver transplantation should be considered using the same criteria as that used for cadaveric transplantation. |
| Keywords: | cancer surgery; graft infection; unclassified drug; clinical trial; histopathology; mortality; cancer recurrence; iodinated poppyseed oil; advanced cancer; artificial embolism; ascites; drug efficacy; liver cell carcinoma; liver cirrhosis; liver function; liver transplantation; patient selection; side effect; carcinoma, hepatocellular; liver neoplasms; conference paper; alpha interferon; nuclear magnetic resonance imaging; antineoplastic agent; neoplasm staging; diagnostic accuracy; cancer immunotherapy; metastasis; quality of life; computer assisted tomography; infection; risk factors; antineoplastic activity; cancer mortality; drug hypersensitivity; postoperative complication; wound; graft failure; adjuvant chemotherapy; fluorodeoxyglucose f 18; radiopharmaceutical agent; liver resection; living donor; hepatectomy; contrast medium; pleura effusion; safety; aspiration biopsy; acetic acid c 11; radiodiagnosis; beta interferon; cholecystitis; portal vein; peroperative care; partial hepatectomy; immunosuppressive agent; antiviral activity; recombinant interleukin 2; respiratory tract disease; iatrogenic disease; monoclonal antibody cd3; fatality; gadolinium chelate; liver arteriography; liver graft; mangafodipir; superparamagnetic iron oxide; liver size; iodinated poppyseed oil i 131; reinfection; humans; prognosis; human; priority journal; cadaver donor; polyprenoic acid |
| Journal Title: | Gastroenterology |
| Volume: | 127 |
| Issue: | Suppl.1 |
| ISSN: | 0016-5085 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2004-11-01 |
| Start Page: | S248 |
| End Page: | S260 |
| Language: | English |
| DOI: | 10.1053/j.gastro.2004.09.039 |
| PROVIDER: | scopus |
| PUBMED: | 15508091 |
| DOI/URL: | |
| Notes: | Gastroenterology -- Cited By (since 1996):136 -- Export Date: 16 June 2014 -- CODEN: GASTA -- Source: Scopus |
