Progress of liver resection for hepatocellular carcinoma in Taiwan

<span class="paragraphSection"><div class="boxTitle">Abstract</div>Taiwan is a well-known endemic area of hepatitis B. Hepatocellular carcinoma (HCC) has consistently been the first or second highest cause of cancer death over the past 20 years. This review article describes the progress of liver resection for HCC in Taiwan in the past half century. The mortality rate for HCC resection was 15 –30% in Taiwan in the 1970s. The rate decreased to 8–12% in the early 1990s, and it declined to<1 –3% recently. The development of new operative instruments, and surgical techniques, increased knowledge of liver anatomy and pathophysiology after hepatectomy, and more precise patient selection have contributed to this improvement. The use of intermittent hepatic inflow blood occlusion, a restri ctive blood transfusion policy and intraoperative ultrasonography, have also led to substantial improvements in resectability and safety for HCC resection in Taiwan. Advances in non-operative modalities for HCC treatment have also helped to improve long-term outcomes of HCC resection. Technical inno vations have allowed the application of complex procedures such as mesohepatectomy, unroofing hepatectomy, major portal vein thrombectomy, hepatic vein reconstruction in resection of the cranial part with preservation of the caudal part of the liver, and inferior vena cava and right atrium tumor thr ombectomy under cardiopulmonary bypass. In selected patients, including patien...
Source: Japanese Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research