HEPATIC RESECTION FOR HEPATOCELLULAR-CARCINOMA

Hepatic resection offers the only chance of cure for patients with hepatocellular carcinoma. Preoperative tumor staging is based on radiologic procedures (ultrasound, CT- and MR-imaging). Compromised hepatic function will limit resectability, leaving only palliative procedures. Unfavorable prognostic tumor factors (diameter >5 cm, multifocal, non-encapsulated, vascular invasion) should lead to a combination of adjuvant chemotherapy/chemoembolization and surgical intervention. In irresectable situations multimodality treatment protocols (combined i.v. chemotherapy, radio-immuno-therapy) play an increasing role.