Skip to main content

Methods to Improve Resectability of Hepatocellular Carcinoma

  • Chapter
  • First Online:
Multidisciplinary Treatment of Hepatocellular Carcinoma

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 190))

Abstract

Liver resection is associated with prolonged survival in selected patients with hepatocellular carcinoma (HCC). Surgical resection of HCC may be decided on an individual basis according to the extent of the tumor and the severity of chronic liver disease. In patients with compensated cirrhosis, the volume of the future liver remnant (FLR) is the most reliable factor for predicting postoperative liver function. Methods of increasing the FLR volume, including portal vein embolization and sequential transarterial chemoembolization in patients who are primarily not eligible for liver resection, have been shown to be safe and have contributed to the increase in the number of surgical candidates.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 179.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 229.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mazzaferro V, Regalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334:693–699

    Article  PubMed  CAS  Google Scholar 

  2. Yao FY, Bass NM, Nikolai B et al (2002) Liver transplantation for hepatocellular carcinoma: analysis of survival according to the intention-to-treat principle and dropout from the waiting list. Liver Transpl 8:873–883

    Article  PubMed  Google Scholar 

  3. Pawlik TM, Esnaola NF, Vauthey JN (2004) Surgical treatment of hepatocellular carcinoma: similar long-term results despite geographic variations. Liver Transpl 10:S74–80

    Article  PubMed  Google Scholar 

  4. Vauthey JN, Chaoui A, Do KA et al (2000) Standardized measurement of the future liver remnant prior to extended liver resection: methodology and clinical associations. Surgery 127:512–529

    Article  PubMed  CAS  Google Scholar 

  5. Chen MS, Li JQ, Zheng Y et al (2006) A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg 243:321–328

    Article  PubMed  Google Scholar 

  6. Kim SH, Lee WJ, Lim HK et al (2009) SPIO-enhanced MRI findings of well-differentiated hepatocellular carcinomas: correlation with MDCT findings. Korean J Radiol 10:112–120

    Article  PubMed  Google Scholar 

  7. Ishizawa T, Hasegawa K, Aoki T et al (2008) Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology 134:1908–1916

    Article  PubMed  Google Scholar 

  8. Makuuchi M, Kosuge T, Takayama T et al (1993) Surgery for small liver cancers. Semin Surg Oncol 9:298–304

    Article  PubMed  CAS  Google Scholar 

  9. Kishi Y, Abdalla EK, Chun YS et al (2009) Three hundred and one consecutive extended right hepatectomies: evaluation of outcome based on systematic liver volumetry. Ann Surg 250:540–548

    PubMed  Google Scholar 

  10. Zorzi D, Laurent A, Pawlik TM et al (2007) Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases. Br J Surg 94:274–286

    Article  PubMed  CAS  Google Scholar 

  11. Truty MJ, Vauthey JN (2010) Uses and limitations of portal vein embolization for improving perioperative outcomes in hepatocellular carcinoma. Semin Oncol 37:102–109

    Article  PubMed  Google Scholar 

  12. Farges O, Belghiti J, Kianmanesh R et al (2003) Portal vein embolization before right hepatectomy: prospective clinical trial. Ann Surg 237:208–217

    PubMed  Google Scholar 

  13. Ribero D, Abdalla EK, Madoff DC et al (2007) Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome. Br J Surg 94:1386–1394

    Article  PubMed  CAS  Google Scholar 

  14. Luo YQ, Wang Y, Chen H et al (2002) Influence of preoperative transcatheter arterial chemoembolization on liver resection in patients with resectable hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int 1:523–526

    PubMed  Google Scholar 

  15. Harada T, Matsuo K, Inoue T et al (1996) Is preoperative hepatic arterial chemoembolization safe and effective for hepatocellular carcinoma. Ann Surg 224:4–9

    Article  PubMed  CAS  Google Scholar 

  16. Sasaki A, Iwashita Y, Shibata K et al (2006) Preoperative transcatheter arterial chemoembolization reduces long-term survival rate after hepatic resection for resectable hepatocellular carcinoma. Eur J Surg Oncol 32:773–779

    Article  PubMed  CAS  Google Scholar 

  17. Zhou WP, Lai EC, Li AJ et al (2009) A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma. Ann Surg 249:195–202

    Article  PubMed  Google Scholar 

  18. Aoki T, Imamura H, Hasegawa K et al (2004) Sequential preoperative arterial and portal venous embolizations in patients with hepatocellular carcinoma. Arch Surg 139:766–774

    Article  PubMed  Google Scholar 

  19. Ogata S, Belghiti J, Farges O et al (2006) Sequential arterial and portal vein embolizations before right hepatectomy in patients with cirrhosis and hepatocellular carcinoma. Br J Surg 93:1091–1098

    Article  PubMed  CAS  Google Scholar 

  20. Yoo H, Kim JH, Ko GY et al (2011) Sequential transcatheter arterial chemoembolization and portal vein embolization versus portal vein embolization only before major hepatectomy for patients with hepatocellular carcinoma. Ann Surg Oncol 18:1251–1257

    Article  PubMed  Google Scholar 

  21. Llovet JM, Ricci S, Mazzaferro V et al (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359:378–390

    Article  PubMed  CAS  Google Scholar 

  22. Cheng AL, Kang YK, Chen Z et al (2009) Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol 10:25–34

    Article  PubMed  CAS  Google Scholar 

  23. Salem R, Lewandowski RJ, Kulik L et al (2011) Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology 140:e492 (497–507)

    Google Scholar 

  24. Regimbeau JM, Farges O, Shen BY et al (1999) Is surgery for large hepatocellular carcinoma justified?. J Hepatol 31:1062–1068

    Article  PubMed  CAS  Google Scholar 

  25. Bruix J, Llovet JM (2002) Prognostic prediction and treatment strategy in hepatocellular carcinoma. Hepatology 35:519–524

    Article  PubMed  Google Scholar 

  26. Young AL, Malik HZ, Abu-Hilal M et al (2007) Large hepatocellular carcinoma: time to stop preoperative biopsy. J Am Coll Surg 205:453–462

    Article  PubMed  Google Scholar 

  27. Pawlik TM, Poon RT, Abdalla EK et al (2005) Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg 140:450–457

    Article  PubMed  Google Scholar 

  28. Ng KK, Vauthey JN, Pawlik TM et al (2005) Is hepatic resection for large or multinodular hepatocellular carcinoma justified?. Results from a multi-institutional database. Ann Surg Oncol 12:364–373

    Article  PubMed  Google Scholar 

  29. Ikai I, Yamamoto Y, Yamamoto N, et al (2003) Results of hepatic resection for hepatocellular carcinoma invading major portal and/or hepatic veins. Surg oncol clin North Am 12(1):65–75.

    Article  Google Scholar 

  30. Shimada M, Takenaka K, Kawahara N et al (1996) Surgical treatment strategy for patients with stage IV hepatocellular carcinoma. Surgery 119:517–522

    Article  PubMed  CAS  Google Scholar 

  31. 31 Poon RT, Fan ST (2003). Evaluation of the new AJCC/UICC staging system for hepatocellular carcinoma after hepatic resection in Chinese patients. Surgical oncology clinics of North America 12:35-50, viii.

    Google Scholar 

  32. Pawlik TM, Poon RT, Abdalla EK et al (2005) Hepatectomy for hepatocellular carcinoma with major portal or hepatic vein invasion: results of a multicenter study. Surgery 137:403–410

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean-Nicolas Vauthey .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Brouquet, A., Andreou, A., Shindoh, J., Vauthey, JN. (2013). Methods to Improve Resectability of Hepatocellular Carcinoma. In: Vauthey, JN., Brouquet, A. (eds) Multidisciplinary Treatment of Hepatocellular Carcinoma. Recent Results in Cancer Research, vol 190. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16037-0_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-16037-0_4

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-16036-3

  • Online ISBN: 978-3-642-16037-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics