| Theme |
Treatment Strategy for Advanced Hepatocellular Carcinoma |
| Title |
Surgical Treatment for Advanced HCC |
| Author |
Nobuyuki Takemura |
Hepato‒Biliary‒Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| Author |
Kiyoshi Hasegawa |
Hepato‒Biliary‒Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| Author |
Norihiro Kokudo |
Hepato‒Biliary‒Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| [ Summary ] |
Only limited therapeutic procedures are indicated for advanced hepatocellular carcinoma (HCC)，representing a relatively unfavorable prognosis. Surgical resection is the only treatment strategy with curative potential for advanced HCC. The indications for surgical resection have expanded concomitantly with technical advances and improvements in the safety of hepatectomy. Even in patients with portal vein tumor thrombus in the main portal trunk or contralateral portal vein, hepatic vein tumor thrombus into the inferior vena cava, and bile duct tumor thrombus causing obstructive jaundice, surgical resection can be indicated. Considering indications for hepatectomy, there is no upper limit for the maximum tumor diameter. Multiple HCCs, occasionally with more than three nodules, ruptured HCCs, and extrahepatic lesions of HCC might also be indicated for surgical resection. Maintaining a satisfactory liver functional reserve and an adequate remnant liver volume are essential conditions for surgical resection of advanced HCC. Surgical resection may contribute to the long‒term survival in patients with advanced HCC, given appropriate patient selection. |