Surgical Resection
Surgical resection is the treatment of choice in
patients without cirrhosis who are in the very early
stage of hepatocellular carcinoma. For patients with cirrhosis, resection produces the best results
when the tumor is small (10 mm Hg) is absent, and the total bilirubin
level is normal (≤1 mg per deciliter [≤17.1 μmol
per liter]).40,41 The 5-year risk of recurrence of hepatocellular
carcinoma after resection is as high
as 70% because the underlying chronic liver disease
continues to put the patient at risk for the
development of new hepatocellular carcinoma. In
the United States, less than 5% of patients are
candidates for hepatic resection. This approach is
much more common in Asian countries, where
there are greater numbers of young people with
HBV-related hepatocellular carcinoma and no or
minimal cirrhosis.