Locations:
Search IconSearch
August 16, 2017/Cancer

Complex Liver Resection As a Curative Surgery for HCC: A Case Study

Skilled team provides advanced surgical interventions

17-DDI-3851-Complex-Liver-CQD-Hero

By Federico Aucejo, MD

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Liver resection continues to be a mainstay treatment for patients presenting with primary and secondary liver malignancies. In the case of hepatocellular carcinoma (HCC), liver resection is a curative alternative. However in HCC patients with cirrhosis and portal hypertension, liver transplantation is the standard of care.

Pretransplant locoregional therapy or liver resection are common approaches to keep patients within transplant eligibility. In line with this, organ allocation in HCC patients undergoing transplantation in the setting of severe organ scarcity continues to be challenging, as accurate predictors of posttransplant tumor recurrence are lacking.

At Cleveland Clinic’s Hepato-Biliary Cancer Center, we offer advanced surgical interventions via sophisticated surgical techniques to patients with complex tumors.

Vignette:

The patient is a 77-year-old male diagnosed with a large, central HCC abutting the portal vein bifurcation. After undergoing evaluation at a large, out-of-state tertiary facility, the patient received locoregional therapy but was denied surgery due to his age and advanced disease.

Seeking a surgical option and therefore a second opinion, the patient consulted the multidisciplinary Liver Tumor Clinic at Cleveland Clinic.

A large R0 central hepatectomy was successfully performed and the patient was discharged from the hospital on post-operative Day 7 without complications.

Liver

Total vascular control (supra-hepatic and infra-hepatic vena cava, and liver hilum) in preparation for parenchymal transection.

Advertisement

Scan

Cross sectional imaging via computed tomography demonstrating a large central liver mass (hepatocellular carcinoma).

Resection

Surgical resection bed (histopathology analysis confirmed negative tumor margins).

References

  1. Murali AR, Romero-Marrero C, Aucejo F, Menon KV. Hepatocellular carcinoma: options for diagnosing and managing a deadly disease. Cleve Clin J Med. 2013 Oct; 80:645-53.
  2. Kumar AM, Fredman ET, Coppa C, ElGazzaz G, Aucejo FN, Abdel-Wahab M. Patterns of cancer recurrence in localized resected hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int. 2015 Jun; 14:269-75.
  3. Sasaki K, Firl DJ, Hashimoto K, Fujiki M, Diago-Uso T, Quintini C, Eghtesad B, Fung JJ, Aucejo FN, Miller CM. Development and validation of the HALT-HCC score to predict mortality in liver transplant recipients with hepatocellular carcinoma: a retrospective cohort analysis. Lancet Gastroenterol Hepatol. 2017 May S2468-1253: 30106-1.
  4. Agopian VG, Harlander-Locke MP, Ruiz RM, et al. Impact of Pre-transplant Bridging Loco-regional Therapy for Patients With Hepatocellular Carcinoma Within Milan Criteria Undergoing Liver Transplantation: Analysis of 3601 Patients from the US Multicenter HCC Transplant Consortium. Ann Surg. 2017 Jun 26. PMID: 28654545

Advertisement

Related Articles

Surgeon
June 30, 2025/Cancer/News & Insight
Potential for Deintensification of Surgical Interventions in Low-Risk Breast Cancer

Reconsidering axillary lymph node dissection as well as depth of surgical margins

Dendritic cell
June 26, 2025/Cancer/News & Insight
Avelumab Induces Natural Killer Cell Activation and Dendritic Cell Crosstalk

Researchers uncover profound differences in the mechanism of action between different PD-L1 checkpoint inhibitors

World map
June 19, 2025/Cancer/News & Insight
Breaking Barriers to Cancer Care: Cleveland Clinic’s Global Approach

A multi-pronged strategy for tackling cancer access problems

CAR T-cell therapy illustration
June 12, 2025/Cancer/News & Insight
First-Ever U.S. Trial of CAR T-Cell Therapy for Relapsed/Refractory AL Amyloidosis

Early results show patients experiencing deep and complete response

Genomic profiling
June 10, 2025/Cancer
Cleveland Clinic’s Hemato-Oncology Team Spearheads the Development of Guidelines for Genomic Profiling of MDS to Inform Allo-HCT

Inclusion of genomic profiling and risk factors recommended for treatment planning

scan showing cholangiocarcinoma
June 5, 2025/Cancer/News & Insight
Exploring Novel Therapeutic Avenues in Advanced Cholangiocarcinoma: Lessons from the EA2187 Trial

Collaborative research effort underscores the urgent need for effective second-line therapies in this rare, aggressive cancer

Anticoagulant sign
June 4, 2025/Cancer/News & Insight
Direct-Acting Oral Anticoagulants Safe for Patients with Brain Metastasis

Largest study to date comparing direct-acting oral anticoagulants to low-molecular-weight heparin

Ad