Hepatocellular Cancer (HCC) is the sixth most common malignancy and third most common cause of cancer-related death worldwide. The incidence of HCC has been found to be increasing in western society with 10 cases reported per 100,000 population annually. Surgery including ablative therapies for HCC remains the mainstay for achieving potential cure. Surgical resection can be performed in non-cirrhotic liver patients using the same criteria as for resection of non-HCC aetiologies. Surgical resection can also be safely performed in patients with cirrhosis when liver function, non-resected future liver volume and portal pressure are carefully analysed and criteria met. In patients whose liver function is poor due to advanced liver disease, liver transplantation can be performed with selection of such recipients based on expected survival at 5 years post transplantation.
The aim of this talk is to provide an overview to the surgical management of HCC in patients with cirrhosis. We will explore the indications for ablation based treatment, surgical resection and when liver transplantation can be considered.