Current Trends in Surgical Management of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Surgical management, including hepatic resection, liver transplantation, and ablation, offers the greatest potential for a curative approach. This review aims to discuss recent advancements in HCC surgery and ident...

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Main Authors: Isabella Angeli-Pahim, Anastasia Chambers, Sergio Duarte, Ali Zarrinpar
Format: Article
Language:English
Published: MDPI AG 2023-11-01
Series:Cancers
Subjects:
Online Access:https://www.mdpi.com/2072-6694/15/22/5378
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author Isabella Angeli-Pahim
Anastasia Chambers
Sergio Duarte
Ali Zarrinpar
author_facet Isabella Angeli-Pahim
Anastasia Chambers
Sergio Duarte
Ali Zarrinpar
author_sort Isabella Angeli-Pahim
collection DOAJ
description Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Surgical management, including hepatic resection, liver transplantation, and ablation, offers the greatest potential for a curative approach. This review aims to discuss recent advancements in HCC surgery and identify unresolved issues in the field. Treatment selection relies on the BCLC staging system, with surgical therapies primarily recommended for early-stage disease. Recent studies have shown that patients previously considered unresectable, such as those with portal vein tumor thrombus and uncomplicated portal hypertension, may benefit from hepatic resection. Minimally invasive surgery and improved visualization techniques are also explored, alongside new techniques for optimizing future liver remnant, ex vivo resection, and advancements in hemorrhage control. Liver transplantation criteria, particularly the long-standing Milan criteria, are critically examined. Alternative criteria proposed and tested in specific regions are presented. In the context of organ shortage, bridging therapy plays a critical role in preventing tumor progression and maintaining patients eligible for transplantation. Lastly, we explore emerging ablation modalities, comparing them with the current standard, radiofrequency ablation. In conclusion, this comprehensive review provides insights into recent trends and future prospects in the surgical management of HCC, highlighting areas that require further investigation.
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spelling doaj.art-f5a81f57bdd04c0d8306c16b419b486f2023-11-24T14:34:09ZengMDPI AGCancers2072-66942023-11-011522537810.3390/cancers15225378Current Trends in Surgical Management of Hepatocellular CarcinomaIsabella Angeli-Pahim0Anastasia Chambers1Sergio Duarte2Ali Zarrinpar3Department of Surgery, College of Medicine, University of Florida, Gainesville, FL 32608, USADepartment of Surgery, College of Medicine, University of Florida, Gainesville, FL 32608, USADepartment of Surgery, College of Medicine, University of Florida, Gainesville, FL 32608, USADepartment of Surgery, College of Medicine, University of Florida, Gainesville, FL 32608, USAHepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Surgical management, including hepatic resection, liver transplantation, and ablation, offers the greatest potential for a curative approach. This review aims to discuss recent advancements in HCC surgery and identify unresolved issues in the field. Treatment selection relies on the BCLC staging system, with surgical therapies primarily recommended for early-stage disease. Recent studies have shown that patients previously considered unresectable, such as those with portal vein tumor thrombus and uncomplicated portal hypertension, may benefit from hepatic resection. Minimally invasive surgery and improved visualization techniques are also explored, alongside new techniques for optimizing future liver remnant, ex vivo resection, and advancements in hemorrhage control. Liver transplantation criteria, particularly the long-standing Milan criteria, are critically examined. Alternative criteria proposed and tested in specific regions are presented. In the context of organ shortage, bridging therapy plays a critical role in preventing tumor progression and maintaining patients eligible for transplantation. Lastly, we explore emerging ablation modalities, comparing them with the current standard, radiofrequency ablation. In conclusion, this comprehensive review provides insights into recent trends and future prospects in the surgical management of HCC, highlighting areas that require further investigation.https://www.mdpi.com/2072-6694/15/22/5378hepatocellular carcinomasurgical managementliver transplantliver resectionablation
spellingShingle Isabella Angeli-Pahim
Anastasia Chambers
Sergio Duarte
Ali Zarrinpar
Current Trends in Surgical Management of Hepatocellular Carcinoma
Cancers
hepatocellular carcinoma
surgical management
liver transplant
liver resection
ablation
title Current Trends in Surgical Management of Hepatocellular Carcinoma
title_full Current Trends in Surgical Management of Hepatocellular Carcinoma
title_fullStr Current Trends in Surgical Management of Hepatocellular Carcinoma
title_full_unstemmed Current Trends in Surgical Management of Hepatocellular Carcinoma
title_short Current Trends in Surgical Management of Hepatocellular Carcinoma
title_sort current trends in surgical management of hepatocellular carcinoma
topic hepatocellular carcinoma
surgical management
liver transplant
liver resection
ablation
url https://www.mdpi.com/2072-6694/15/22/5378
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AT alizarrinpar currenttrendsinsurgicalmanagementofhepatocellularcarcinoma