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.