Michael Choti MD, Presenter: Nothing to Disclose

1) To understand the available choices for surgical management of hepatocellular carcinoma, including resection, transplantation, and ablation. 2) To interpret the most recent data regarding the efficacy of each of these surgical modalities. 3) To understand the controversies regarding indications and contraindications for hepatic resection and transplantation.

Hepatocellular carcinoma (HCC) is responsible for a significant amount of morbidity and mortality throughout the world. Of particular interest, in many countries, including the United States, there is a definite increase in the incidence of HCC that has been reported recently, largely attributable to the increasing incidence of hepatitis C infection. Unfortunately, the current management of HCC is confusing. Numerous treatment options confront the team of healthcare providers caring for a patient with HCC. The difficulty of managing a patient with HCC is compounded by a lack of well-designed randomized clinical trials comparing the various treatment modalities. Nevertheless, there are many exciting management options currently available that may prove valuable in the treatment of this disease. Partial hepatic resection or, in some instances, liver transplantation provides the best chance for cure. However, various ablative therapies including radiofrequency ablation, microwave ablation, and cryosurgery may result in survival benefit. Systemic chemotherapy and transarterial chemoembolization employed either alone or as adjuncts to ablation or resection, may play an increasing role in palliating or downstaging a patient with advanced HCC in the future. An overview of the state-of-the-art in HCC management is presented with an attempt to guide the practicing physician in selecting the best surgical treatment plan for an individual with HCC.

Choti, M, Hepatocellular Carcinoma: Surgical Treatment.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6007084.html