Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 18, 2015; 7(20): 2237-2240
Published online Sep 18, 2015. doi: 10.4254/wjh.v7.i20.2237
Role of liver resection in the management of multinodular hepatocellular carcinoma
Osman Abbasoglu
Osman Abbasoglu, Department of Surgery, Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey
Author contributions: Abbasoglu O performed the literature review and prepared the manuscript; Abbasoglu O solely contributed to this paper.
Conflict-of-interest statement: The author whose name is listed immediately below certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Osman Abbasoglu, Department of Surgery, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara 06100, Turkey. osmanabbasoglu@yahoo.com
Telephone: +90-532-3649039 Fax: +90-312-4262421
Received: May 14, 2015
Peer-review started: May 14, 2015
First decision: June 24, 2015
Revised: August 2, 2015
Accepted: September 1, 2015
Article in press: September 2, 2015
Published online: September 18, 2015
Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer related deaths worldwide. Various treatment modalities have been applied to HCC depending on the tumor load, functional capacity of the liver and the general condition of the patient. According to Barcelona Clinic Liver Cancer staging strategy and The American Association for the Study of Liver Disease guidelines, surgical resection is not advocated in the tretment of multinodular HCC. Despite this, many recent clinical studies show that, resection can achieve good results in patients with multinodular HCC and 5-year survival rate around 40% can be reached. If resection or transplantation is not performed, these patients are usually managed with palliative procedures such as transarterial chemoembolization, radioembolization and cytotoxic chemotherapy and 5-year survival of this group of patients will be extremely low. Although survival rates are lower and complications may be increased in this group of patients, liver resection can safely be performed in selected patients in experienced centers for the management of multinodular HCC.

Keywords: Hepatocellular carcinoma, Hepatoma, Liver resection, Transarterial chemoembolization, Liver cancer, Liver transplantation

Core tip: Liver resection is underutilized in the management of multinodular hepatocellular carcinoma. The presence of multiple nodules should not be considered as a contraindication for surgical resection. Acceptable 5-year survival rates can be achieved in selected patients.