Hepatic Resection in Hepatocellular Carcinoma Management

Hepatic resection constitutes the standard of care for early-stage hepatocellular carcinoma in patients with adequate hepatic reserve and solitary tumours. It achieves the highest rate of oncological clearance, translating into superior survival compared with non-surgical modalities. Advances in preoperative assessment—such as dynamic volumetry and indocyanine green clearance testing—have enhanced patient selection and minimised postoperative hepatic failure. Minimally invasive techniques, including laparoscopic and robotic approaches, have reduced perioperative morbidity and accelerated recovery. Emerging evidence supports the judicious extension of resection to selected intermediate-stage patients when combined with neoadjuvant or adjuvant therapies to address microscopic residual disease. Integration of biomarkers, notably alpha-fetoprotein levels and genomic signatures, into perioperative algorithms is refining risk stratification. Within multidisciplinary frameworks, hepatic resection remains pivotal, with ongoing trials poised to clarify its synergistic potential alongside evolving systemic and immune-based treatments.

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Hepatic Resection in Hepatocellular Carcinoma Management publication trend

The graph below shows the total number of articles in hepatic resection in hepatocellular carcinoma management across all publications each year (not limited to Nature Index journals).

Technical terms

Hepatic resection: Surgical removal of tumour-bearing liver tissue with curative intent.

Hepatocellular carcinoma: Primary malignancy arising from hepatocytes, often in the context of chronic liver disease.

BCLC staging system: Classification scheme stratifying HCC by tumour extent, liver function and performance status to guide treatment selection.

Transarterial chemoembolisation (TACE): Locoregional therapy delivering chemotherapy and embolic particles via the hepatic artery to induce tumour ischaemia.

Propensity score matching: Statistical method pairing patients with similar baseline characteristics to reduce selection bias in observational studies.

Recurrence-free survival (RFS): Interval from treatment to detection of tumour recurrence or last follow-up.

Overall survival (OS): Duration from treatment to death from any cause or last follow-up.

Immune checkpoint inhibitors (ICIs): Agents targeting regulatory pathways in T cells to enhance antitumour immune responses.

References

1. Adjuvant immunotherapy improves recurrence-free and overall survival following surgical resection for intermediate/advanced hepatocellular carcinoma a multicenter propensity matching analysis. Frontiers in Immunology (2024).
2. Liver resection versus transarterial chemoembolisation for the treatment of intermediate hepatocellular carcinoma: a systematic review and meta-analysis. International Journal of Surgery (2023).