Resection of hepatocellular carcinoma.

The majority of hepatocellular carcinoma occurs in patients with liver cirrhosis. Although the tumors are often discovered at an early stage during surveillance of these patients, the underlying cirrhosis renders the surgery more difficult and exposes the patients to higher rates of postoperative morbidity and mortality than occurs in other types of liver surgery. Over the past 20 years surgeons have developed new surgical procedures and techniques to firstly reduce the unnecessary resection of liver parenchyma and to decrease intraoperative blood loss. Better patient selection and understanding of prognostic factors will hopefully result in a further decrease in operative risk and postoperative recurrence. Adjuvant chemotherapy may prove effective in reducing the postoperative recurrence but at this stage surgery still remains as the best treatment for patients with recurrent tumor which is accessible to resection.