Resection of hepatocellular carcinoma

The majority of hepatocellular carcinoma occurs in patients with liver cirr hosis. Although the tumors are often discovered at an early stage during su rveillance of these patients, the underlying cirrhosis renders the surgery more difficult and exposes the patients to higher rates of postoperative mo rbidity and mortality than occurs in other types of liver surgery. Over the past 20 years surgeons have developed new surgical procedures and techniqu es to firstly reduce the unnecessary resection of liver parenchyma and to d ecrease intraoperative blood loss. Better patient selection and understandi ng of prognostic factors will hopefully result in a further decrease in ope rative risk and postoperative recurrence. Adjuvant chemotherapy may prove e ffective in reducing the postoperative recurrence but at this stage surgery still remains as the best treatment for patients with recurrent tumor whic h is accessible to resection.