HEPATOCELLULAR CARCINOMA

CURRENT SURGICAL MANAGEMENT

Abstract

This review focuses on the surgical management of the hepatocellular carcinoma, an important complication of hepatic cirrhosis. Therefore, hepatic cirrhosis must be
thought as a pre-malignant disease. B hepatitis and C chronic hepatitis are also important risk factors. When it reaches around 5 cm of diameter, the regenerative nodule begins to loose differentiation and to invade vessels. Only 15% of the diagnosed hepatocellular carcinomas may be surgically resected with curative criteria. Differential diagnosis with other hepatic tumors is made by ar terial phase of computed tomography. The only potentially curative treatment to hepatocellular carcinoma is surgery. This could be performed by partial hepatic resection or total hepatic resection followed by hepatic transplantation. Child C cirrhotic patients should not be submitted to a partial hepatic resection. The only available treatment for them is hepatic transplantation. Presently, cirrhotic patients with hepatocellular carcinoma could be submitted to liver transplantation only if they have a single nodule of less than 5 cm of diameter or if they have up to three nodules of less than 3 cm of diameter each. The 5-year survival period of patients that underwent a liver transplantation may be as high as 70%.