Wang D, Xiao M, Wan ZM, Lin X, Li QY, Zheng SS. Surgical treatment for recurrent hepatocellular carcinoma: Current status and challenges. World J Gastrointest Surg 2023; 15(4): 544-552 [PMID: 37206072 DOI: 10.4240/wjgs.v15.i4.544]
Corresponding Author of This Article
Shu-Sen Zheng, MD, PhD, Chief Physician, Doctor, Division of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, No. 848 Dongxin Road, Hangzhou 310000, Zhejiang Province, China. shusenzheng@zju.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Apr 27, 2023; 15(4): 544-552 Published online Apr 27, 2023. doi: 10.4240/wjgs.v15.i4.544
Surgical treatment for recurrent hepatocellular carcinoma: Current status and challenges
Di Wang, Min Xiao, Zhen-Miao Wan, Xin Lin, Qi-Yong Li, Shu-Sen Zheng
Di Wang, Zhen-Miao Wan, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
Di Wang, Min Xiao, Zhen-Miao Wan, Xin Lin, Qi-Yong Li, Shu-Sen Zheng, Division of Hepatobiliary and Pancreatic Surgery, Jinan Microecological Biomedicine Shandong Laboratory, Jinan 250000, Shandong Province, China
Min Xiao, Xin Lin, Qi-Yong Li, Shu-Sen Zheng, Division of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou 310000, Zhejiang Province, China
Author contributions: All authors contributed to data collection, analysis, drafting, or revising the article, have agreed on the journal to which the article will be submitted, gave final approval to the version to be published, and agree to be responsible for all aspects of the work.
Supported bythe Jinan Microecological Biomedicine Shandong Laboratory, No. JNL-2022022C; and the Health Commission of Zhejiang Province, No. JBZX-202004.
Conflict-of-interest statement: The authors report no conflicts of interest in this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Sen Zheng, MD, PhD, Chief Physician, Doctor, Division of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, No. 848 Dongxin Road, Hangzhou 310000, Zhejiang Province, China. shusenzheng@zju.edu.cn
Received: December 6, 2022 Peer-review started: December 6, 2022 First decision: December 19, 2022 Revised: January 5, 2023 Accepted: March 21, 2023 Article in press: March 21, 2023 Published online: April 27, 2023 Processing time: 138 Days and 1 Hours
Abstract
Primary liver cancer is the sixth most commonly diagnosed cancer and was the third leading cause of cancer deaths worldwide in 2020. It includes hepatocellular carcinoma (HCC) (representing 75%-85% of cases), intrahepatic cholangiocarcinoma (representing 10%-15% of cases), and other rare types. The survival rate of patients with HCC has risen with improved surgical technology and perioperative management in recent years; however, high tumor recurrence rates continue to limit long-term survival, even after radical surgical resection (exceeding 50% recurrence). For resectable recurrent liver cancer, surgical removal [either salvage liver transplantation (SLT) or repeat hepatic resection] remains the most effective therapy that is potentially curative for recurrent HCC. Thus, here, we introduce surgical treatment for recurrent HCC. Areas Covered: A literature search was performed for recurrent HCC using Medline and PubMed up to August 2022. Expert commentary: In general, long-term survival after the re-resection of recurrent liver cancer is usually beneficial. SLT has equivalent outcomes to primary liver transplantation for unresectable recurrent illness in a selected group of patients; however, SLT is constrained by the supply of liver grafts. SLT seems to be inferior to repeat liver resection when considering operative and postoperative results but has the major advantage of disease-free survival. When considering the similar overall survival rate and the current situation of donor shortages, repeat liver resection remains an important option for recurrent HCC.
Core Tip: This article reviews the previous literature reports on the statistics of surgical treatment of recurrent liver cancer, mainly including re-hepatectomy and salvage liver transplantation. This article focuses on the analysis and comparison of the respective advantages and disadvantages of these two methods and proposes a future vision.
