Page 18 - 台灣肝癌醫學冬季會手冊-1222-V3_Neat

Surgical treatment of hepatocellular carcinoma

Wei-Chen Lee

Chief,Department of Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of
Medicine.

Hepatocellular carcinoma (HCC) is one of the most common malignancy in Taiwan. The treatment
options for HCC included surgery, radiofrequency ablation, TACE, radiotherapy, chemotherapy,
immunotherapy, and so on. The choice of these treatment depends on the stages of the tumors. In the

early stage of HCC, surgery remains the most effective treatment and yields the best results.
Surgical treatments include liver resection and liver transplantation. According to BCLC guideline,
liver resection is one of treatments for early stage HCC. If portal hypertension is not present, liver
resection will be the choice of treatment. Currently, the 5-year disease-free and overall survival of

liver resection for early stage HCC is around 50% and 70%. Not only early stage HCC, but also some
tumor in advanced stages such as ipsilateral portal vein thrombus or solitary distant metastasis may
need surgery to yield a better survival. Liver transplantation is another option of surgical treatment for
HCC, which solves cirrhosis and HCC simultaneously. When the tumors are within a certain

condition, liver transplantation can achieve the best disease-free survival and more than 70% of 5-
year survival. However, liver transplantation is limited by availability of donor grafts.
Treatment of HCC has much progression in recent years. Surgical treatments remain the gold
standard to free from tumors. If effective adjuvant treatment is available, the results of surgical

treatment may be further improved.