Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12473
Revised: January 28, 2014
Accepted: April 1, 2014
Published online: September 21, 2014
The incidence of hepatocellular carcinoma (HCC) is increasing worldwide, largely due to hepatitis B virus (HBV), hepatitis C virus and liver cirrhosis. Chronic HBV infection is estimated to cause 55%-60% of the cases of HCC worldwide and over 70% in Asian countries. Liver resection is currently the mainstay of treatment due to the low surgical mortality, a wider treatment indication, and simplicity of post-treatment follow-up. There is an ever-increasing demand on surgeons to perform curative liver resection in HCC, with the hope of avoiding tumor recurrences. Hepatitis B-related-HCC has distinct clinicopathological features, which should be considered when treating the disease. The author presents a review of the recently evolving strategies and emerging therapies to improve HCC postresectional outcomes and focus on perioperative measures to improve patient outcome, with particular reference to the current status of adjuvant therapies in HCC patients after liver resection.
Core tip: Chronic hepatitis B virus infection is the main cause of hepatocellular carcinoma (HCC). Liver resection is currently the mainstay of treatment. However, the postresectional tumor recurrence rates remain high. There is an ever-increasing demand on surgeons to perform curative liver resection in HCC, with the hope of avoiding tumor recurrences. The author presents a review of the recently evolving strategies and emerging therapies to improve patient outcomes, including a policy of accurate preoperative staging, adequate resection, intensive postoperative follow-up, and early initiation of effective adjuvant therapy, with particular reference to the current status of adjuvant therapies in HCC patients after liver resection.