BackTable Vascular & Interventional Ep. 521 Surgery for HCC: What’s its Role Today?
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Feb 28, 2025 Dr. Siddharth Padia, an interventional radiologist at UCLA, and Dr. John Seal, a transplant and hepatobiliary surgeon at Ochsner Clinic, dive deep into the complexities of hepatocellular carcinoma treatment. They discuss the delicate balance between surgical resection and liver transplantation, influenced by factors like liver health and patient condition. The conversation highlights advancements in living donor transplantation and crucial communication about treatment expectations, all while navigating challenges like organ availability and evolving surgical techniques.
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Defining 'Cure' in HCC
- Avoid using the word "cure" with HCC patients, as it can create unrealistic expectations.
- Patients with HCC often develop new tumors, so managing expectations is crucial.
Resection vs. Transplant
- Consider resection for HCC patients with minimal underlying liver disease or small, peripheral tumors.
- For patients with cirrhosis or larger, centrally located tumors, prioritize transplant.
Radiation Lobectomy for HCC
- Use radiation lobectomy cautiously for HCC, as results have not been as promising as hoped.
- Portal vein embolization for FLR hypertrophy in HCC patients also faces challenges.