Dr. Kukar during surgery

Liver Cancer Surgery

Surgery remains the primary, first-line treatment to be considered. Liver surgery aims to remove the tumor or tumors from the liver, or to remove the portion of the liver that contains the cancer.

American College of Surgeons Quality badges

If the rest of the liver is healthy – up to 80% of the liver can be removed – and the remaining portion of healthy liver can regenerate. If the rest of the liver has chronic disease with functional damage such as seen with liver cirrhosis, limited surgery may be possible but the overall best treatment may be through ablation or regional embolization procedures.

Your cancer will be classified (in addition to staging) according to whether it can be treated effectively with surgery:

  • Localized resectable – cancer is found only in the liver and can be completely removed by surgery.
  • Localized and locally-advanced unresectable – cancer is only in the liver but cannot be completely removed by surgery.
  • Advanced – cancer has spread throughout the liver or has spread to other body sites. For cancers that started within the liver (liver-cell cancer or bile duct cancer), this means that surgery should not be performed.

Liver surgery is a complex operation, requiring the skill and experience of surgeons who focus on these procedures. Roswell Park is a high-volume center, performing more than 100 major liver procedures each year, including minimally invasive, laparoscopic and traditional open approaches.

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What if I'm not a candidate for liver surgery?

Neoadjuvant treatments may make surgery possible

If you have been told that your cancer is unresectable or you have been called medically inoperable, you should consult with a liver cancer surgeon at Roswell Park. We offer several preoperative (or, neoadjuvant) treatments that may make effective surgery possible for you. These include:

  • preoperative radiation to shrink the tumor
  • preoperative chemotherapy to shrink the tumor
  • portal vein embolization to stimulate regeneration of healthy liver tissue prior to the definitive surgery

With these neoadjuvant treatments, patients with advanced disease or cancer that is borderline resectable may have their tumors downsized before the operation, allowing:

  • Complete and possibly curative tumor removal
  • Non-surgical candidates at diagnosis to still undergo surgery
  • Decreased risk of major complications

Outcomes better than the national benchmark

Liver cancer surgery is highly complex and should be done only by hepatobiliary surgeons with extensive experience. Roswell Park is a high-volume center for both liver and pancreas surgery, and over the last 7 years, the 30-day and in-hospital mortality for both liver and pancreas resection has been less than 3% — better than the national average for this important quality measure.

Am I eligible for a liver transplant?

All Roswell Park liver cancer patients are screened to determine whether undergoing a liver transplant would be a potential treatment option. Unfortunately, the simple fact is that more than 80% of liver cancer patients are not candidates for this type of organ transplant. Of the select few who are candidates, only one in 10 on the liver transplant wait list receive a transplant. We can advise you how and where to seek an expert evaluation regarding liver transplantation.

If you are a candidate for a liver transplant, Roswell Park can also provide treatments such as ablation, as “bridge-to-transplant” therapies.