What is liver resection and why is it done?

Liver resection is the surgical removal of a portion of the liver. This operation is usually done to remove various types of liver tumors that are located in the resected portion of the liver. The goal of liver resection is to completely remove the tumor and the appropriate surrounding liver tissue without leaving any tumor behind.

Which patients with liver cancer undergo liver resection?

In patients with liver cancer (Hepatocellular Cancer, HCC), this treatment option, liver resection, is limited to patients with one or two small (3cm or less) tumors and excellent liver function, ideally without associated cirrhosis. As a result of these strict guidelines, in practice, very few patients with HCC can undergo liver resection. The biggest concern about resection is that following the operation, the patient can develop liver failure. The liver failure can occur if the remaining portion of the liver is inadequate (e.g., because of associated cirrhosis) to provide the necessary support for life. Even in carefully selected patients, about 10% of them are expected to die shortly after surgery, usually as a result of liver failure.

Does the resected liver grow back?

When a portion of a normal liver is removed, the remaining liver can grow back (regenerate) to the original size within one to two weeks. A cirrhotic liver, however, cannot grow back. Therefore, before resection is performed for HCC, the non-tumor portion of the liver should be biopsied to determine whether there is associated cirrhosis.

What are the results (survival and recurrence) of liver resection?

For HCC patients whose tumors are successfully resected, the five-year survival is about 30 to 40%. This means that 30 to 40 % of patients who actually undergo liver resection for HCC are expected to live five years. Many of these patients, however, will have a recurrence of HCC elsewhere in the liver. Moreover, it should be noted that the survival rate of untreated patients with similar sized tumors and similar liver function is probably comparable. Some studies from Europe and Japan have shown that survival rates with alcohol injection or radiofrequency ablation procedures are comparable to the survival rates of those HCC patients who underwent resection. But the reader should be cautioned that there are no head-to-head comparisons of these procedures versus resection for the treatment of HCC.

To read more about Hepatocellular Carcinoma (HCC), please read the MedicineNet.com Liver Cancer (Hepatocellular Carcinoma) article.

Medical Author: Tse-Ling Fong, M.D.
Medical Editor: Leslie J. Schoenfield, M.D., Ph.D.

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