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At this time, surgery, either with resection (removal of the
tumor) or a liver transplant, offers the only reasonable chance to cure
liver cancer. If all known cancer in the liver (a partial hepatectomy)
is successfully removed, you will have the best outlook for survival.
Unfortunately, complete removal of most liver cancers is not
possible. Often the cancer has spread beyond the liver, it has become
quite large or is present in too many different parts of the liver, or
the person is not healthy enough for surgery.
More than 4 out of 5 people with liver cancer in the United
States also have cirrhosis. If you have severe cirrhosis, removing even
a small amount of liver tissue at the edges of your cancer might not
leave enough to perform essential functions. People with cirrhosis are
eligible for surgery only if the cancer is small and they still have a
reasonable amount of liver function left. Doctors often assess this
function by assigning a Child-Pugh score (see the section "How
is liver cancer staged?"), which is a measure of cirrhosis
based on certain lab tests and symptoms. Patients who fall into class A
are most likely to have enough liver function to have surgery. Patients
in class B are less likely to be eligible for surgery. Surgery is not
typically an option for those in class C.
Possible risks and side effects
Liver resection is a major, serious operation that should only
be done by skilled and experienced surgeons. Because people with liver
cancer usually 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 adequate liver function.
A large amount of blood passes through the liver at any given
time, and bleeding after surgery is a major concern. On top of this,
the liver normally makes substances that help the blood clot. Damage to
the liver (both before the surgery and during the surgery itself) can
add to potential bleeding problems.
Other possible problems are similar to those seen with other
major surgeries and can include infections, complications from
anesthesia, and pneumonia.
Another concern is that because the remaining liver still
contains the underlying disease that led to the cancer, sometimes a new
liver cancer can develop afterward.
Last Medical Review: 12/07/2008
Last Revised: 05/12/2009
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