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At this time, surgery, either by resection (removal of the
tumor) or liver transplantation, offers the only reasonable chance to
cure a liver cancer. If removal of all known cancer in the liver (a
partial hepatectomy) is successful, 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 or has become
quite large or may be present in too many different parts of the liver.
Your ability to have liver surgery also depends on the health
of the parts of your liver not affected by the cancer. About 4 out of
5 people with liver cancer in the United States also have
cirrhosis. If you have severe cirrhosis, the removal of 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 "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 for surgery. Other
options are considered for those in class B and C, although partial
hepatectomy is sometimes done in people whose liver function is
class B.
Another important factor is the skill of your surgical team.
Liver
resection is a major, serious operation that should only be done by
skilled and experienced surgeons.
A possible problem with partial
hepatectomy is that sometimes a new liver cancer can develop
afterwards, because the liver
still contains the underlying disease that led to the first one.
Last Revised: 05/03/2007
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