Liver cancer treatment options: resection and transplantation

Liver Cancer Treatment: Resection vs. Transplant—Which Option is Best?

Nico Varela in Health & Wellness December 2025 • 4 min read.

"Navigating the complexities of liver cancer treatment: a comprehensive comparison of hepatic resection and liver transplantation for optimal outcomes."

When facing a diagnosis of liver cancer, also known as hepatocellular carcinoma (HCC), understanding the available treatment options is crucial. Among the most effective approaches are hepatic resection (HR), which involves surgically removing the cancerous portion of the liver, and liver transplantation (LT), where the diseased liver is replaced with a healthy one.

Both HR and LT offer the potential for a cure, but they are not suitable for all patients. The choice between these two depends on several factors, including the stage and size of the tumor, the overall health of the liver, and the presence of underlying liver disease such as cirrhosis. Determining the best course of action requires a comprehensive evaluation by a team of specialists.

This article will explore the recent advances in both hepatic resection and liver transplantation for hepatocellular carcinoma, providing insights into patient selection, surgical techniques, and outcomes. By understanding the nuances of each procedure, patients and their families can make informed decisions in consultation with their healthcare providers.

Hepatic Resection: When Removing the Tumor is an Option

Liver cancer treatment options: resection and transplantation

Hepatic resection is often the preferred treatment for HCC when the tumor is confined to the liver and the remaining liver function is adequate. The goal of HR is to remove the tumor completely while preserving as much healthy liver tissue as possible. This approach is particularly effective for single, smaller tumors in livers without advanced cirrhosis.

Several factors are considered when determining if a patient is a candidate for hepatic resection:

Tumor Size and Location: Smaller tumors located in easily accessible areas of the liver are ideal for resection.
Liver Function: Patients must have sufficient liver function to tolerate the removal of a portion of their liver. This is assessed through various liver function tests, including the indocyanine green retention rate (ICG-R15).
Absence of Cirrhosis: While HR can be performed in patients with mild cirrhosis, it is generally not recommended for those with advanced cirrhosis due to the increased risk of complications.
Overall Health: Patients must be in good overall health to undergo major surgery.

Recent advancements in surgical techniques, such as minimally invasive approaches and improved methods for controlling bleeding, have made HR safer and more effective. Additionally, preoperative portal vein embolization (PVE) can be used to increase the size of the future liver remnant, reducing the risk of liver failure after resection.

Making Informed Decisions for Liver Cancer Treatment

Both hepatic resection and liver transplantation play crucial roles in the management of hepatocellular carcinoma. HR offers a chance for cure when the tumor is resectable and liver function is adequate, while LT provides an option for patients with advanced disease or underlying cirrhosis.

The decision between HR and LT should be made in consultation with a multidisciplinary team of experts, including surgeons, hepatologists, and oncologists. These specialists can assess the individual patient's situation and recommend the most appropriate treatment strategy.

Ongoing research continues to refine the selection criteria and surgical techniques for both HR and LT, offering hope for improved outcomes and prolonged survival for patients with liver cancer. A multi-modality treatment strategy, especially for patients with advanced HCC, provides new fields of investigation for diverse indications of HR and LT.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5124/jkma.2013.56.11.956, Alternate LINK

Title: Recent Advances In Hepatic Resection And Liver Transplantation For Hepatocellular Carcinoma

Subject: General Medicine

Journal: Journal of the Korean Medical Association

Publisher: Korean Medical Association (KAMJE)

Authors: Shin Hwang

Published: 2013-01-01

Everything You Need To Know

What is Hepatic Resection and how does it help in the treatment of liver cancer?

Hepatic resection (HR) involves surgically removing the cancerous portion of the liver, aiming to cure the cancer by completely removing the tumor while preserving as much healthy liver tissue as possible. It is typically favored for single, smaller tumors located in easily accessible areas in livers without advanced cirrhosis. The significance of HR lies in its potential for a cure, offering a chance at long-term survival for suitable candidates. However, the success of HR hinges on factors like the size and location of the tumor, the overall health of the liver, and the absence of cirrhosis.

What is Liver Transplantation and why is it considered for liver cancer treatment?

Liver transplantation (LT) involves replacing the diseased liver with a healthy one, offering a solution for hepatocellular carcinoma (HCC) when other options are not feasible. LT is often considered for patients with advanced disease or underlying cirrhosis, as it addresses both the cancer and the compromised liver function. The importance of LT is its ability to provide a new, healthy liver, potentially curing the cancer and improving the overall health of the patient. The implications of LT involve the need for lifelong immunosuppression to prevent rejection of the new liver, which can increase the risk of infections and other complications.

What factors influence the choice between Hepatic Resection and Liver Transplantation?

The primary factors determining the best treatment, either hepatic resection (HR) or liver transplantation (LT), include the stage and size of the tumor, the overall health of the liver, and the presence of underlying liver disease like cirrhosis. For instance, if the tumor is small, confined, and the liver is healthy without cirrhosis, HR might be the preferred option. However, if the tumor is advanced, or the patient has significant liver damage or cirrhosis, LT might be the better choice. Determining the best course of action necessitates a comprehensive evaluation by a team of specialists. The key to success is a tailored approach, considering the nuances of each procedure, so patients can make informed decisions.

What are the key requirements for someone to be a candidate for Hepatic Resection?

Hepatic resection (HR) is considered when the tumor is confined to the liver, the tumor is smaller, located in easily accessible areas of the liver, and the remaining liver function is adequate. The patient should not have advanced cirrhosis. This is determined by assessing tumor size and location, liver function tests such as the indocyanine green retention rate (ICG-R15), the absence of cirrhosis, and overall health. Recent advances include minimally invasive approaches and improved methods for controlling bleeding, making HR safer. Preoperative portal vein embolization (PVE) can be employed to increase the size of the future liver remnant, reducing the risk of liver failure.

How do Hepatic Resection and Liver Transplantation compare in the context of liver cancer treatment?

Both hepatic resection (HR) and liver transplantation (LT) have crucial roles in managing hepatocellular carcinoma (HCC). HR provides a chance for a cure if the tumor is resectable and liver function is adequate. LT offers an option for those with advanced disease or cirrhosis. The choice depends on cancer stage, tumor size, liver function, and overall health. HR aims at removing the tumor while preserving healthy liver tissue, and LT replaces the diseased liver with a healthy one. Both have the potential for cure but are suitable for different patient profiles and require a thorough assessment by specialists.