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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 18, 2016; 8(11): 513-519
Published online Apr 18, 2016. doi: 10.4254/wjh.v8.i11.513
Published online Apr 18, 2016. doi: 10.4254/wjh.v8.i11.513
Hepatic resection beyond barcelona clinic liver cancer indication: When and how
Mattia Garancini, Enrico Pinotti, Stefano Nespoli, Fabrizio Romano, Luca Gianotti, Vittorio Giardini, Department of Surgery, Hepatobiliopancreatic Unit, San Gerardo Hospital, University of Milano Bicocca, 20900 Monza, Italy
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting, critical revision, editing, and final approval of the final version.
Conflict-of-interest statement: All authors have no potential conflicts of interest and no financial support to declare.
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: Mattia Garancini, MD, Department of Surgery, Hepatobiliopancreatic Unit, San Gerardo Hospital, University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy. mattia_garancini@yahoo.it
Telephone: +39-039-2339783 Fax: +39-039-2339783
Received: September 11, 2015
Peer-review started: September 11, 2015
First decision: October 27, 2015
Revised: February 18, 2016
Accepted: March 24, 2016
Article in press: March 25, 2016
Published online: April 18, 2016
Peer-review started: September 11, 2015
First decision: October 27, 2015
Revised: February 18, 2016
Accepted: March 24, 2016
Article in press: March 25, 2016
Published online: April 18, 2016
Core Tip
Core tip: According to the barcelona clinic liver cancer (BCLC) classification liver resection should be performed only in patients with small single hepatocellular carcinoma of 2-3 cm without signs of portal hypertension (PHT). Nevertheless, many studies have shown that patients with multiple and large hepatocellular carcinoma, as like as those with macrovascular infiltration and PHT, could benefit from liver resection. Consequently BCLC algorithm should be updated and revised. The aim of this review was to analyze when and how liver resection could be indicated beyond BCLC indications. In this perspective, the role of multidisciplinary approach, of intraoperative ultrasound and of laparoscopy have been enhanced.