Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC

With rising incidence and emergence of effective treatment options, the management of hepatocellular carcinoma (HCC) is a complex multidisciplinary process. There is still little consensus and uniformity about clinicopathological staging systems. Resection and liver transplantation have been the cor...

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Main Authors: Rahul Deshpande, Derek O'Reilly, David Sherlock
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:International Journal of Hepatology
Online Access:http://dx.doi.org/10.4061/2011/686074
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author Rahul Deshpande
Derek O'Reilly
David Sherlock
author_facet Rahul Deshpande
Derek O'Reilly
David Sherlock
author_sort Rahul Deshpande
collection DOAJ
description With rising incidence and emergence of effective treatment options, the management of hepatocellular carcinoma (HCC) is a complex multidisciplinary process. There is still little consensus and uniformity about clinicopathological staging systems. Resection and liver transplantation have been the cornerstone of curative surgical treatments with recent emergence of ablative techniques. Improvements in diagnostics, surgical techniques, and postoperative care have lead to dramatically improved results over the years. The most appropriate treatment plan has to be individualised and depends on a variety of patient and tumour-related factors. Very small HCCs discovered on surveillance have the best outcomes. Patients with advanced cirrhosis and tumours within Milan criteria should be offered transplantation. Resection is best for small solitary tumours with preserved liver function. Ablative techniques are suitable for low volume tumours in patients unfit for either resection or transplantation. The role of downstaging and bridging therapy is not clearly established.
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series International Journal of Hepatology
spelling doaj-art-548c7b1fa46641f7a6797b0dca3b95072025-08-20T03:34:20ZengWileyInternational Journal of Hepatology2090-34482090-34562011-01-01201110.4061/2011/686074686074Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCCRahul Deshpande0Derek O'Reilly1David Sherlock2Department of Hepatobiliary Surgery, North Manchester General Hospital, Crumpsall, Manchester M8 5RB, UKDepartment of Hepatobiliary Surgery, North Manchester General Hospital, Crumpsall, Manchester M8 5RB, UKDepartment of Hepatobiliary Surgery, North Manchester General Hospital, Crumpsall, Manchester M8 5RB, UKWith rising incidence and emergence of effective treatment options, the management of hepatocellular carcinoma (HCC) is a complex multidisciplinary process. There is still little consensus and uniformity about clinicopathological staging systems. Resection and liver transplantation have been the cornerstone of curative surgical treatments with recent emergence of ablative techniques. Improvements in diagnostics, surgical techniques, and postoperative care have lead to dramatically improved results over the years. The most appropriate treatment plan has to be individualised and depends on a variety of patient and tumour-related factors. Very small HCCs discovered on surveillance have the best outcomes. Patients with advanced cirrhosis and tumours within Milan criteria should be offered transplantation. Resection is best for small solitary tumours with preserved liver function. Ablative techniques are suitable for low volume tumours in patients unfit for either resection or transplantation. The role of downstaging and bridging therapy is not clearly established.http://dx.doi.org/10.4061/2011/686074
spellingShingle Rahul Deshpande
Derek O'Reilly
David Sherlock
Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC
International Journal of Hepatology
title Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC
title_full Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC
title_fullStr Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC
title_full_unstemmed Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC
title_short Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC
title_sort improving outcomes with surgical resection and other ablative therapies in hcc
url http://dx.doi.org/10.4061/2011/686074
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