Surgery is the most effective treatment for primary liver cancer (HCC). The type of operation you have depends on the number of tumours 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 – your liver is removed and replaced with a liver from another person (a donor)
- a liver resection – the surgeon removes the part of your liver where the cancer is.
Your surgeon and specialist nurse will tell you whether surgery is a possible option for you. They will explain what it involves and the possible complications or risks. An operation to your liver is major surgery. It is important to have all the information you need before you decide.
The most common reason for a liver transplant is if a person has liver disease that is too advanced for other treatments. A liver transplant is only suitable for some people with HCC.
It can only be done if you have:
- a single tumour that is 5cm or less in size
- a single tumour that is between 5cm and 7cm, which does not grow over six months
- up to five tumours that are 3cm or less.
You need to be reasonably fit to cope with a transplant. Your liver team will assess you very carefully to make sure it is a suitable treatment for you. Your specialist also needs to be confident that the cancer cells have not spread.
It can take time, perhaps months, for a donor liver to become available. You may have other treatments to help control the cancer during this time. 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 transplanted into you after your diseased liver is removed.
After a transplant, you need to take drugs called immunosuppressants for the rest of your life. These stop your body from rejecting the new liver. But they make your immune system less able to fight any cancer cells that have spread.
Recovering from a liver transplant takes a long time. You have to gradually build up your health and fitness. It can take many months before you get back to doing everyday activities. We have not 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.
This operation is usually suitable for people who:
- have a single tumour or a limited number of tumours
- do not have cirrhosis, or have early-stage cirrhosis.
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 or tumours. 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 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 ablation treatment during surgery. This uses heat to destroy cancer cells.