Recent advances in the surgical treatment of hepatocellular carcinoma

Table 2 Summary of recent advances in liver resection for hepatocellular carcinoma

Established

Screening and early detection for high-risk patients (i.e., with HCV or HBV infection, alcoholic, metabolic chronic liver disease, etc.)

Diagnosis with contrast-enhanced imaging for the detection of early lesions

Assessment of liver function (Child-Pugh classification, indocyanine green retention test, MELD score)

Modulation of residual liver function with preoperative portal vein embolization

Anatomic resection removing undetectable disseminated tumor foci in the same portal territory

Under discussion

Three dimensional-CT-assisted preoperative surgical planning facilitates:

Unconventional types of liver resection

Laparoscopic liver resection could be beneficial:

For patients with severe liver dysfunction with lower morbidity

For repeat resection

As a bridging therapy for liver transplantation

Under trial or proposal

Adjuvant and/or combined therapy for advanced tumor

Sorafenib

Intraarterial 5-FU plus IFN therapy for hepatocellular carcinoma with VTT

CT: Computed tomography; HBV: Hepatitis B virus; HCV: Hepatitis C virus; IFN: Interferon; MELD: Model for end-stage liver disease; VTT: Venous tumor thrombosis; 5-FU: 5-Fluorouracil.