Surgery for liver cancer

At this time, surgery offers the only likely chance to cure liver cancer. Surgery is done either to remove the tumor or to do a liver transplant.

Removing part of the liver (partial hepatectomy)

Surgery to remove the part of the liver with the cancer is called a partial hepatectomy. If all of the cancer the surgeon can see at the time of the operation can be removed, you have the best outlook for survival. But complete removal of most liver cancers is not possible. Often the cancer is large, is found in many different parts of the liver, or has spread beyond the liver. Also, many people with cirrhosis do not have enough healthy liver left to make this kind of surgery an option.

Risks and side effects: People with liver cancer often have damage to the other parts of their liver. Surgeons have to remove enough of the liver to try to get all of the cancer, yet leave enough behind for the liver to work the way it needs to.

A lot of blood passes through the liver at any given time, and bleeding after surgery is a major concern. On top of this, the liver makes substances that help the blood clot. Damage to the liver (both before the surgery and during the surgery itself) can add to possible bleeding problems. Another concern is that because the remaining liver still contains the damage that led to the cancer, a new liver cancer may develop later.

Liver transplant

A liver transplant may be an option for some people with small liver cancers. For now, transplant is usually saved for those with a few small tumors that cannot be totally removed, either because of where they are found or because not enough normal liver would be left.

Not many livers are available for transplant for patients with cancer because they are most often used for more curable diseases. Patients often must wait a long time – often too long – for a liver to be found. For this reason, some doctors suggest other treatments while a person is waiting for a new liver. Or a person may get a partial hepatectomy first and then a transplant if the cancer comes back.

Most livers for transplants come from people who have just passed away. But in recent years, a small number of patients have received part of a liver from a living donor (usually a close relative). The liver can regain some of its lost function over time if part of it is removed. Still, the surgery does carry some risks for the donor. A few hundred living donor transplants are done in the United States each year, but only a small number of them are for people with liver cancer.

Possible risks and side effects of a liver transplant: People who get a liver transplant have the same surgery risks as listed above. They also have to be given drugs to help suppress the immune system and prevent the body from rejecting the new organ. These drugs have their own risks and side effects, especially the risk of getting serious infections. Some of the drugs used to prevent rejection can also cause other health problems.