Surgical resection for hepatocellular carcinoma

The incidence of hepatocellular carcinoma (HCC) is growing in the United States due to increasing rates of cirrhosis from viral hepatitis, alcohol, and fatty liver disease. The elevated incidence, along with the associated high mortality rate for patients with this diagnosis, highlights the importance of an understanding of the optimal management of HCC. Surgical resection and liver transplantation offer the only options for long-term cure. However, without careful patient selection, meticulous intraoperative technique and perioperative management, liver resection in patients with underlying cirrhosis is associated with a significant risk of postoperative morbidity and/or mortality. This article will describe key considerations in patient selection and recent improvements in surgical technique and peri-operative management that have increased the safety of liver resection in patients with HCC, particularly those with underlying cirrhosis.