Abstract
The optimal treatment for hepatocellular carcinoma (HCC) should be selected based on tumor conditions, liver functional reserve, and performance status. Surgical treatment, such as liver resection and liver transplantation, is the most favorable treatment method; however, its indication criteria differ according to each country’s guidelines. In Western countries, liver resection is indicated only for early-stage HCC patients with Barcelona-Clinic Liver Cancer staging classification (BCLC) 0/A. While in Asian countries, liver resection is one of the treatment options for advanced HCC, such as BCLC B/C. Recently, the treatment of HCC is about to enter a drastic transitional period. It started with the widespread use of minimally invasive surgery for HCC, followed by a high rate of hepatitis C virus eradication with the advent of direct acting antivirals and developing a multidisciplinary treatment for highly advanced HCC. As a result, the importance of liver resection for HCC is increasing, and it is time to reconsider the criteria for selecting treatment methods for HCC patients. This article outlines current topics in the surgical treatment of HCC.
Highlights
hepatocellular carcinoma (HCC) with vascular invasion are considered as very advanced stage, and liver resection is not recommended in Western countries
Subgroup analysis of the 1309 patients with HCC larger than 3 cm in size revealed that the 90-day mortality rate in the liver resection group was extremely low at 0.57%, and a five-year overall survival rate was significantly better in the liver resection group than the transarterial chemoembolization (TACE) group (53% vs. 32.7%)
We have reviewed current topics in the treatment of HCC, with a focus on surgical treatment
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Hepatocellular carcinoma (HCC) accounts for the majority of primary malignancy of the liver. It is the fifth most common cancer and is the second leading cause of cancerrelated death worldwide [1]. In Asian countries, liver resection is recommended even for advanced HCC [3,4,5]. In Western countries, liver resection is indicated only for a limited number of patients with early HCC, and liver transplantation is recommended for others [6,7]. This article will discuss the current topics of the surgical treatments for HCC by comprehensive search of PubMed, EMBASE, and Cochrane library, taking into account the differences among countries and regions
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