Liver resection is one of the main curative options for early hepatocellular carcinoma (HCC) in patients with cirrhosis and is the treatment of choice in non-cirrhotic patients. However, careful patient selection is required to balance the risk of postoperative liver failure and the potential benefit on long-term outcomes. In the last decades, improved surgical techniques and perioperative management, as well as better patient selection, have enabled the indications for liver resection to be expanded. In this review, we aim to describe the main indications for liver resection in the management of HCC, its role compared to percutaneous ablation and liver transplantation in the therapeutic algorithm, as well as the recent advances in liver surgery that could be used to improve the prognosis of patients with HCC.
Keywords: ALPPS, associating liver partition and portal vein ligation for staged hepatectomy; BCLC, Barcelona Clinic liver cancer; CSPH, clinically significant portal hypertension; DFS, disease-free survival; GSA, galactosyl serum albumin; HCC; HCC, hepatocellular carcinoma; HVGP, hepatic venous pression gradient; ICG, indocyanine green; ICG-R15, hepatic clearance of ICG 15 minutes after its intravenous administration; IL-6, interleukin 6; LR, liver resection; LSM, liver stiffness measurement; Laparoscopy; Liver resection; MELD, model for end-stage liver disease; NAFLD, non-alcoholic fatty liver disease; OS, overall survival; PVL, portal vein ligation; PVTT, tumour-related portal vein thrombosis; RFA, radiofrequency ablation; SSM, spleen stiffness measurement; Surgery; TACE, transarterial chemoembolisation.
© 2020 The Authors.