title: Severity of liver cirrhosis: a key role in the selection of surgical modality for Child-Pugh A hepatocellular carcinoma.
abstract: Hepatocellular carcinoma is the third leading cause of cancer-related death in the world, and cirrhosis is the main cause of hepatocellular carcinoma and adversely affects surgical outcomes. Liver resection, liver transplantation, and local ablation are potentially curative therapies for early hepatocellular carcinoma (HCC). There exists an obvious histological variability of severity within cirrhosis which has different clinical stages. For patients with Child-Pugh B cirrhosis and/or portal hypertension and HCC within Milan criteria, consensus guidelines suggest that liver transplantation is the best treatment of choice; liver resection is widely accepted as first-line treatment for patients with early-stage HCC and preserved liver function; and local ablation is the treatment of choice in patients with small tumors who are not candidates for surgery or can be used as a temporary treatment during the waiting period for transplantation. For patients with compensated cirrhosis or Child A cirrhosis, the selection of surgical modality based on subclassification of cirrhosis remains unclear. This review examines the current status of the selection of surgical modality for hepatocellular carcinoma treatment in cirrhotic patients and aims to emphasize the effects of the severity of cirrhosis on the selection of surgical modality for the treatment of hepatocellular carcinoma.
authors: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Da Dao, Wuhan, 430030, China. baiyu19861104@163.com.
authors: Er-lei
authors: EL
authors: Zhang
authors: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Da Dao, Wuhan, 430030, China. 158117273@qq.com.
authors: Bin-yong
authors: BY
authors: Liang
authors: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Da Dao, Wuhan, 430030, China. chenxpchenxp@163.com.
authors: Xiao-ping
authors: XP
authors: Chen
authors: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Da Dao, Wuhan, 430030, China. zyhuang@medmail.com.cn.
authors: Zhi-yong
authors: ZY
authors: Huang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D009367:Neoplasm Staging; D011379:Prognosis; D012720:Severity of Illness Index