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Laparoscopic Resection of Hepatocellular Carcinoma

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Multidisciplinary Treatment of Hepatocellular Carcinoma

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 190))

Abstract

The current treatment of HCC is truly multidisciplinary. Notwithstanding, surgical management remains the gold standard which other therapies are compared to. Operative management is divided into transplantation and resection; the latter is further subdivided among open and laparoscopic approaches. Resection has become safer, remains superior to locoregional treatments, and can be a life-prolonging bridge to transplantation. The decision to pursue laparoscopic resection for HCC is driven by safety and a view toward the long-term management of both the malignancy and the underlying liver disease. For patients with a solitary HCC <5 cm in segments 2, 3, 4b, 5, and 6, no evidence of extrahepatic tumor burden, compensated liver disease, and the absence of significant portal hypertension, laparoscopy has an important role. Under these circumstances, resection can be performed with reduced mortality and morbidity and equivalent oncologic outcomes, disease-free survival, and overall survival when compared with similarly selected cirrhotic patients undergoing open resection. Blood loss and transfusion requirements are low, and laparoscopy itself does not expose the patient to complications and does not increase the risk of cancer recurrence or dissemination. Finally, because HCC recurrence remains high in the cirrhotic liver, treatment following surgical resection mandates routine surveillance and treatment by locoregional therapy, reresection, or transplantation as required—the latter two of which are facilitated by an initial laparoscopic resection.

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Abbreviations

HCC:

Hepatocellular carcinoma

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Authors and Affiliations

  1. Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, Room 734, New York, NY, 10065, USA

    Michael D. Kluger & Daniel Cherqui

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  1. Michael D. Kluger
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  2. Daniel Cherqui
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Correspondence to Daniel Cherqui .

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Editors and Affiliations

  1. M.D. Anderson Cancer Center, Dept. Surgical Oncology, University of Texas, Holcombe Blvd. 1515, Houston, 77030, Texas, USA

    Jean-Nicolas Vauthey

  2. , Dept. of Surgical Oncology, MD Anderson Cancer Center, Holcombe Boulevard, Unit 444 1515, Houston, 77030, USA

    Antoine Brouquet

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Kluger, M.D., Cherqui, D. (2013). Laparoscopic Resection of Hepatocellular Carcinoma. In: Vauthey, JN., Brouquet, A. (eds) Multidisciplinary Treatment of Hepatocellular Carcinoma. Recent Results in Cancer Research, vol 190. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16037-0_8

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