What is surgery and what is it used for?

Surgery is the most effective treatment for HCC but it’s only suitable for a small number of people. The type of operation will depend on the number of tumours in the liver and how damaged the liver is from chronic liver disease.

There are two types:

  • Liver transplant – this removes your liver and replaces it with a liver from another person (a donor). Your doctor may recommend it if your liver is too damaged for a resection. A transplant is only suitable if the tumour(s) is small and no cancer cells have spread. You also need to be reasonably fit. It may take months for a liver to become available and recovery after a transplant is a slow process.
  • Liver resection – this operation only removes the part of the liver where the cancer is. It is only suitable if you have a single tumour and you do not have cirrhosis or have early cirrhosis.

An operation to the liver is major surgery. It’s important to have all the information you need before making your decision.

Surgery

Surgery is the most effective treatment for HCC. The type of operation you have depends on the number of tumours that are in the liver and how damaged the liver is from chronic liver disease. Only a small number of people with HCC can have surgery. There are two types of operation:

  • a liver transplant, where your liver is removed and replaced with a liver from another person (a donor).
  • a liver resection, where they remove only the part of your liver where the cancer is.

Your surgeon and specialist nurse will tell you if surgery is a possible option for you. They will explain what it involves and what the possible complications or risks are. An operation to your liver is major surgery, so it’s important to have all the information you need before you decide.


Liver transplant

A specialist may recommend a liver transplant if your liver is too damaged for you to have a resection, or there are many tumours in the liver. You need to be reasonably fit to cope with a transplant. Your liver team will assess you very carefully to make sure it’s a suitable treatment for you. Your specialist also needs to be confident that the cancer cells have not spread.

After a transplant, you need to take drugs called immunosuppressants for the rest of your life so your body doesn’t reject the new liver. But these drugs make the immune system less able to fight any cancer cells that have spread.

In HCC, a liver transplant can only be done if you have:

  • a single tumour that is 5cm or less in size
  • a single tumour between 5cm and 7cm that doesn't grow over six months
  • up to five tumours of 3cm or less.

It can take time – perhaps months – for a liver to become available. You may have other treatments to help control the cancer during this time. Unfortunately, in some people the cancer may progress so that a transplant is no longer possible.

Sometimes it may be possible to have part of a liver transplanted from a living donor. This is a newer type of operation and is only available in a few hospitals. The donor has surgery to remove a lobe of their liver, which is then immediately transplanted.

Recovering from a liver transplant is a long, slow process. You have to gradually build up your health and fitness. It can take many months before you get back to doing everyday activities.

We haven’t provided detailed information here about your care before or after a liver transplant. Your specialist liver team will talk to you about what to expect before and after the operation.


Liver resection

This operation is usually suitable for people who:

  • have a single tumour
  • don’t have cirrhosis, or have cirrhosis that is still at an early stage.

The surgeon removes the part of the liver where the cancer is. The amount of liver they remove depends on the size and position of the tumour(s). They may remove only a small part of the liver or a whole lobe of the liver (called a hemi-hepatectomy). But your liver needs to be working well so that the remaining liver can cope after the operation.

In some hospitals, a resection may be done using keyhole surgery (laparoscopic surgery). Some people also have radiofrequency ablation during surgery. This uses heat to destroy cancer cells.

Back to Surgery explained

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.

What happens after surgery?

You’ll be monitored closely after your operation. How long you stay in hospital will depend on the operation you have.