[Surgical therapy of hepatocellular carcinoma].
Hepatocellular carcinoma (HCC) accounts for most primary malignancies of the liver. The most important risk factor is liver cirrhosis. HCC can be traced by the tumor marker alpha-fetoprotein. Patients with a known liver cirrhosis should regularly be screened, including sonography and alpha-fetoprotein evaluation. Surgical therapy - either partial liver resection or liver transplantation - is the only treatment that can potentially achieve long-term survival. The presence of liver cirrhosis is likely to induce postoperative liver insufficiency and is associated with higher local tumor recurrence rate. Patients without liver cirrhosis or Child-Pugh A patients with tumors smaller than 5 cm may be considered as the ideal target group for resection. For more advanced stages of cirrhosis and tumors of less than 5 cm up to 7 cm in size, liver transplantation offers a better prognosis. Long waiting time for a suitable organ negatively influences liver transplantation outcome. Living donor liver transplantation is a novel therapeutic option that improves posttransplant survival and extends the indication for transplantation in hepatocellular carcinoma.
Frilling
A
A
Klinik für Allgemein- und Transplantationschirurgie, Universitätsklinikum Essen. frilling@uni-essen.de
Frühauf
N
N
Sotiropoulos
G C
GC
Cicinnati
V
V
Malago
M
M
Broelsch
C E
CE
D006528:Carcinoma, Hepatocellular / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis; D008113:Liver Neoplasms / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D010166:Palliative Care; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D036542:Tomography, Spiral Computed