Klin Onkol 2020; 33(Suppl 3): 30-33. DOI: 10.14735/amko202030.
Surgical treatment of hepatocellular carcinoma (HCC) is part of multimodal treatment and consists of liver resection or transplantation. Unfortunately, only 30% of patients with HCC are primarily surgically treatable. The indication for surgery is based on the patient‘s biological condition, the extent of the disease, the function of the liver parenchyma and the residual volume of the liver. For liver resections, we choose anatomical resections. In case of insufficient residual volume of the liver, we have a possibility of staged procedures to increase the resectability of HCC. Liver transplantation solves not only the HCC itself, but also advanced underlying liver disease (cirrhosis) and is based primarily on the Milan indication criteria. The long-term results of surgical treatment depend on the progress of HCC. In HCC detected in the initial stage, the five-year survival of patients is 60–80%. In patients in whom radical resection or transplantation of the liver cannot be performed for various reasons, palliative methods, today mainly thermoablation, or transarterial chemoembolization or radioembolization are possible. In some patients, liver resection or transplantation can be performed after embolization.
