Liver resection in the treatment of hepatocellular carcinoma.

Hepatocellular carcinoma is a leading cause of cancer death worldwide. Liver resection and liver transplantation remain the only options for cure. Since the indications for orthotopic liver transplantation are limited, partial liver resection is the more common treatment. Recently, indications for liver resection have been expanded and there have been advances in the associated surgical techniques. This review describes the state-of-the-art of liver resection for hepatocellular carcinoma. Topics covered include: new indications, such as treatment of large tumors, bilobar tumors and those associated with vascular invasion; preoperative assessment of liver function; and surgical strategies. An overview of the most common staging systems, which are useful in predicting prognosis after liver resection for hepatocellular carcinoma, is given.