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World J Gastroenterol. Jul 28, 2014; 20(28): 9237-9244
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9237
Hepatectomy for hepatocellular carcinoma in the era of liver transplantation
Wen-Ping Lu, Jia-Hong Dong
Wen-Ping Lu, Jia-Hong Dong, Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Lu WP and Dong JH designed and wrote the article.
Supported by Grants from the National Natural Science Foundation of China, No. 30772493 and No. 81170429
Correspondence to: Jia-Hong Dong, Professor, MD, PhD, FACS, Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. wenping_lv@126.com
Telephone: +86-10-66938030 Fax: +86-10-68241383
Received: December 5, 2013
Revised: March 5, 2014
Accepted: June 13, 2014
Published online: July 28, 2014
Abstract

The aim of management of hepatocellular carcinoma (HCC) is to improve the prognosis of the patients by radical resection and preserve remnant liver function. Although liver transplantation is associated with a lower tumor recurrence rate, this benefit is counteracted by long-term complications. Therefore, hepatectomy could be the first choice of treatment in selected patients with HCC. However, the higher frequency of tumor recurrence and the lower rate of resectability after hepatectomy for HCC led to an unsatisfactory prognosis. New strategies are required to improve the long-term outcome of HCC after hepatectomy. In this paper, we introduce some strategies to increase the low rate of resectability and reduce the high rate of tumor recurrence. Some aggressive treatments for tumor recurrence to extend long-term survival are also involved. We believe that hepatectomy combined with other therapies, such as portal vein embolization, transarterial chemoembolization, radioembolization, antiviral treatment, radiofrequency ablation and salvage transplantation, is a promising treatment modality for HCC and may improve survival greatly.

Keywords: Hepatocellular carcinoma, Hepatectomy, Prognosis

Core tip: We discuss the new strategies to improve the long-term outcome of hepatocellular carcinoma after hepatectomy.