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Debate: Resection for Early Hepatocellular Carcinoma

  • 2008 ssat other
  • Published:
Journal of Gastrointestinal Surgery

Abstract

The management of patients with cirrhosis and early hepatocellular carcinoma (HCC) meeting the Milan criteria is controversial. Although liver transplantation for early HCC has been shown to have excellent long term survival rates and low recurrence rates, its application is limited by organ availability. Hepatic resection is an alternative therapy for early HCC. Hepatic resection can be performed safely in patients with early HCC and well-compensated cirrhosis. In addition, the reported 5-year survival rates are in the range of 50%. Resection may also allow a better understanding of tumor biology through pathologic examination of the specimen while also providing a potentially curative therapeutic option. The management of patients with early HCC is complex. Resection should not be viewed as opposing transplantation. Rather, hepatic resection should be seen as complementary to transplantation. The best therapeutic strategies for patients with early HCC and well-compensated cirrhosis should be dependent on the individual clinical situation, not adherence to dogmatic universal adoption of either resection or transplantation.

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Authors and Affiliations

  1. Departments of Surgery, Johns Hopkins School of Medicine, 600 North Wolfe Street, Halsted 614, Baltimore, MD, 22187-6681, USA

    Timothy M. Pawlik

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  1. Timothy M. Pawlik
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Correspondence to Timothy M. Pawlik.

Additional information

This paper was originally presented as part of an SSAT Controversies in GI Surgery debate entitled, “Hepatocellular Carcinoma in the Mild Cirrhotic: Transplant or Resect?”, at the SSAT 49th Annual Meeting, May 2008, in San Diego, California. The other article presented in the debate was Kim RD and Hemming AW, “Hepatocellular Carcinoma: Resection or Transplantation.”

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Pawlik, T.M. Debate: Resection for Early Hepatocellular Carcinoma. J Gastrointest Surg 13, 1026–1028 (2009). https://doi.org/10.1007/s11605-008-0779-1

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  • DOI: https://doi.org/10.1007/s11605-008-0779-1

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