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Chok. Hepatoma Res 2017;3:189-95 Hepatoma Research
DOI: 10.20517/2394-5079.2017.33
www.hrjournal.net
Topic: Management of Huge and Advanced Hepatocellular Carcinoma Open Access

Surgical strategy for huge and advanced

hepatocellular carcinoma in Hong Kong

Kenneth S.H. Chok

Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong, China.
Correspondence to: Prof. Kenneth S.H. Chok, Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Department of Surgery, The
University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China. E-mail: kennethchok@gmail.com
How to cite this article: Chok KSH. Surgical strategy for huge and advanced hepatocellular carcinoma in Hong Kong. Hepatoma Res 2017;3:189-95.

ABSTRACT

Article history: In Hong Kong, surgical resection is the core curative treatment for huge and advanced
Received: 31-07-2017 hepatocellular carcinoma (HCC). For tumors measuring 10 cm or above, major hepatectomy
Accepted: 09-08-2017 is usually required, but a future liver remnant not large enough will preclude the operation.
Published: 03-09-2017 Hypertrophy of future liver remnant is a way to render more patients operable, and measures
include portal vein embolization and associating liver partition and portal vein ligation
Key words: for staged hepatectomy. For HCC that has invaded a major vessel, en bloc resection with
Associating liver partition and immediate vessel reconstruction is necessary if thrombectomy would not suffice. In case of
portal vein ligation, bilobar involvement, radiofrequency ablation is a useful adjuctive therapy. In the treatment of
staged hepatectomy, extrahepatic metastasis, metastasectomy offers a cure to properly selected patients.
hepatocellular carcinoma,
liver resection,
vascular resection and
reconstruction,
radiofrequency ablation

INTRODUCTION curative treatment. Fan et al. reported 5-year survival
[3]
rates of 73% and 81% achieved by partial hepatectomy
Hepatocellular carcinoma (HCC) is the sixth most and living donor liver transplantation respectively in
common cancer and is the most common primary patients within the Milan criteria.
[1]
liver malignancy worldwide. Like hepatitis B, it is
most prevalent in Asia; at the same time, most cases In the case of huge and advanced HCC, treatment is
of HCC on the continent are related to hepatitis B, more limited. Only transarterial chemoembolization
and Hong Kong is no exception. Diagnoses of HCC (TACE) and systemic therapy are recommended
[2]
are mostly made at a late stage as regular screening in Western countries, [4-7] but more aggressive
for the disease is uncommon, and the disease often management is adopted in Hong Kong. A newly
develops in a multifocal manner and infiltrates into developed Hong Kong liver cancer (HKLC) staging is
major vessels. As such, surgical resection is a common now in use. In the study by Yau et al., surgery had
[8]
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