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Surgery for early stage hepatocellular carcinoma
Luis Cesar Bredt1, Tiago Cesar Mierzwa1, Alex Francovig Rachid1, Francisco Guilherme Fernandes1, Julio Cezar Zanini1
1Department of Abdominal Surgery, Hepatobiliary Section, Cancer Hospital-UOPECCAN, Cascavel, PR, Brasil.

Article ID: 100033IJHPDLB2015
doi:10.5348/ijhpd-2015-33-RA-8

Address correspondence to:
Luis César Bredt
Rua Dom Pedro II, 2099
ap 701, Centro, Cascavel, Paraná
Brasil, Postal Code: 85812-270
Phone: +55(45) 9936-9943
Fax: +55(45)2101-7005

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How to cite this article
Bredt LC, Mierzwa TC, Rachid AF, Fernandes FG, Zanini JC. Surgery for early stage hepatocellular carcinoma. Int J Hepatobiliary Pancreat Dis 2015;5:47–55.


Abstract
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide, and the curative treatment is available only for tumors detected in early stage. In a critical analysis of the therapeutic options in early stage HCC three potential curatives therapies are possible in early stage HCC: total hepatectomy with liver transplantation (LT), partial hepatectomy and radiofrequency ablation (RFA) of very small tumors. Total hepatectomy with LT has proven to be the best treatment for operable and resectable disease (BCLC 0 and A) in a cirrhotic liver, the liver resection, RFA, transarterial chemoembolization (TACE) or percutaneous injection of alcohol (PIA) can be considered for those patients with waiting list time up to six months. Partial hepatectomy as definitive therapy should be used only for patients with patients in Child-Pugh A and B without portal hypertension. In patients with inoperable but localized disease (BCLC A), the RFA or PIA can be indicated.

Keywords: Early Stage, Hepatocellular carcinoma, Therapeutic options, Curative treatments


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Author Contributions
Luis Cesar Bredt – Substantial contributions of Conception and design, acquisition of data; revising it critically for important intellectual content; final approval of the version to be published
Tiago Cesar Mierzwa – Substantial contributions of Conception and design, acquisition of data, Analysis and interpretation of data, drafting the article; final approval of the version to be published
Alex FrancovigRachid – Substantial contributions of Conception and design, acquisition of data, drafting the article; final approval of the version to be published
Francisco GuilhermeFernandes – Analysis and interpretation of data; revising it critically for important intellectual content; final approval of the version to be published
Julio Cezar Zanini – Analysis and interpretation of data; revising it critically for important intellectual content; final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Luis Cesar Bredt et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.