Surgical approach to hepatocellular carcinoma: a review

Abstract

Hepatocellular carcinoma (HCC) is a primary liver cancer that arises in the setting of chronic liver inflammation and/or cirrhosis. Despite advancements in screening and treatment, the incidence and mortality of HCC continue to increase. Treatment for HCC is guided by a patient’s liver function, performance status, and extent of tumor burden. Patients with early-stage HCC are often treated with surgery, liver transplantation, or liver-directed therapy. Unfortunately, many patients have limited surgical options due to advanced-stage disease, recurrent disease after resection, or pre-existing moderate to severe liver dysfunction. These patients are subsequently treated with a combination of atezolizumab and bevacizumab, or durvalumab and tremelimumab. Operative management of HCC requires experienced surgeons and a multidisciplinary team of medical oncologists, radiation oncologists, and hepatologists for appropriate patient selection. Due to the complex management required for these patients, it is critical that the surgical management is informed by updated guidelines and data. We herein review the surgical management and treatment considerations for patients with HCC.

Keywords

Surgery / hepatocellular carcinoma / resection

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