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Surgical Resection of High-Risk Hepatocellular Carcinoma: Patient Selection, Preoperative Considerations, and Operative Technique

  • EMERGING THERAPEUTIC APPROACHES TO HEPATOCELLULAR CARCINOMA
  • Published:
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Abstract

Hepatocellular carcinoma remains a leading cause of cancer death worldwide. There are an increasing number of patients that do not meet traditional criteria for surgical resection as a result of historically poor outcomes. We define these oncologically high-risk patients as those with either one of these risk factors or a combination of them: large (>5 cm) primary tumors, multinodular disease, and/or major vascular invasion. With appropriate selection and preparation, long-term survival is possible in this subset of patients after resection. This review focuses on the surgical treatment of these high-risk patients, focusing on our own institution’s approach and methods as well as reviewing the literature pertinent to the support of our current practice.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    Mark J. Truty MD, MSc & Jean-Nicolas Vauthey MD

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  1. Mark J. Truty MD, MSc
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  2. Jean-Nicolas Vauthey MD
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Correspondence to Jean-Nicolas Vauthey MD.

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Author disclosures: Dr. Truty has nothing to disclose. Dr. Vauthey has received grant support from Sanofi-aventis, has participated in the Speakers Bureau of Sanofi-aventis, and has participated in the Speakers Bureau of Genentech.

Acknowledgement: This educational review is part of a series, “Emerging Therapeutic Approaches to Hepatocellular Carcinoma,” which has been supported by an educational grant from Onyx Pharmaceuticals/Bayer Healthcare Pharmaceuticals.

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Truty, M.J., Vauthey, JN. Surgical Resection of High-Risk Hepatocellular Carcinoma: Patient Selection, Preoperative Considerations, and Operative Technique. Ann Surg Oncol 17, 1219–1225 (2010). https://doi.org/10.1245/s10434-010-0976-5

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  • DOI: https://doi.org/10.1245/s10434-010-0976-5

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