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Digestive Disease Interventions 2017; 01(02): 094-104
DOI: 10.1055/s-0037-1603811
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of Hepatectomy for Hepatocellular Carcinoma in the Era of Transplantation and Locoregional Therapy

Nicholas Latchana
1   Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Christopher McQuinn
1   Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Richard Burkhart
2   Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland
,
Samantha Lahey
1   Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Timothy M. Pawlik
1   Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
› Author Affiliations
Further Information

Publication History

19 December 2016

04 May 2017

Publication Date:
08 June 2017 (online)

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Abstract

Hepatocellular carcinoma (HCC) remains the most common primary liver neoplasm and is a leading cause of cancer-related mortality worldwide. Therapeutic options are increasing in HCC and now include surgical resection, transplantation, local ablation, directed transarterial therapies, and systemic therapies. Efficacy for each modality varies widely with the chance for cure dictated predominantly by disease biology. Surgical extirpation remains the mainstay of therapy in a curative paradigm. The role of hepatectomy and transplantation, however, has evolved as multidisciplinary management and now integrates other locoregional and systemic therapies. Herein, we review the modern approach to HCC within the context of historical trials. Studies informing a current practice that combine surgery with locoregional therapies are highlighted. A variety of transarterial options are critically examined and selection criteria for use are suggested. Finally, current best-practice guidelines are discussed with updates and practical advice where warranted.

Keywords

hepatocellular carcinoma - hepatectomy - liver transplantation - transarterial chemoembolization - transarterial radioembolization - sorafenib