Liver Cancer Surgery & Surgical Oncology Procedures

Surgery for Liver Cancer

At Cancer Treatment Centers of America (CTCA), our expert surgical oncologists are skilled in providing patients with sophisticated and innovative liver cancer surgery options.

Liver cancers are classified based on whether or not they can be completely removed (resected). Depending on the size and location of the tumor, it may be removed by partial or total surgery of the liver.

• Localized resectable cancers are those that can be completely removed by surgery; only a small number of patients with liver cancer have such tumors.
• Localized unresectable cancers are those that have not spread to the lymph nodes or distant organs but cannot be completely removed by surgery. This may be because the non-cancerous part of the liver is not healthy, the cancer has spread throughout the liver, or the tumor is close to the main arteries, veins and bile ducts.
• Advanced cancers have spread to lymph nodes or other organs beyond the liver and cannot be treated with surgery.

Your care team at CTCA will determine whether liver cancer surgery is the right treatment option for you. If surgery is recommended, it may be part of a treatment plan that includes radiation therapy, chemotherapy or other treatments.

Liver Cancer Surgery: Partial Hepatectomy

In some cases, surgery to remove the cancerous portion of the liver may be a treatment option. This procedure is known as a partial hepatectomy, or liver resection. The goal in performing liver resection surgery is to prevent the cancer from continuing to spread.

Our surgical oncologists regularly perform liver resection procedures. They can be done as either a traditional, open surgical procedure or as a less invasive, laparoscopic procedure.

Patients who undergo laparoscopic liver resection tend to:

• Experience less pain
• Have a shorter stay in the hospital
• Recover more quickly
• Resume other treatments (e.g., chemotherapy) more quickly because they recover from surgery in less time than with open surgery
• Have less scarring/better cosmetic appearance where incisions are made

To determine if liver resection surgery is possible, several factors are considered, including:

• The extent of the disease in the liver – If multiple liver tumors, large liver tumors and tumors in multiple lobes of the liver are present, they may not be able to be surgically removed.
• The extent of the surgery needed – A significant enough portion of the liver that is healthy must remain in order for it to function properly.
• Tumors near blood vessels in the liver – Liver tumors near blood vessels may be inoperable. Other treatments such as intra-arterial chemotherapy or chemoembolization may be more appropriate options.
• Cirrhosis – Patients who have cirrhosis typically do not tolerate liver resection.

Robotic-assisted Surgery for Liver Cancer

The da Vinci^® Surgical System offers a minimally invasive option for performing liver cancer surgery. The sophisticated robotic surgical platform enables our surgical oncologists to remove difficult-to-reach tumors in the liver with increased precision, vision, dexterity and control.

With da Vinci, a surgeon first makes small incisions in a patient’s upper abdomen to insert miniaturized instruments and a high-definition camera. The patient’s anatomy appears on a viewer as a highly magnified, high-resolution 3D image.

With eyes and hands in line with the instruments, the surgeon uses the controls below the viewer to move the instrument arms and camera. The system then translates, in real time, the surgeon’s hand, wrist and finger movements into precise movements of the instruments inside the patient.

Throughout the procedure, the surgeon controls every surgical maneuver. The system cannot be programmed or act in any way without the surgeon’s input.

Because the da Vinci system requires such small incisions and offers greater vision, precision and control for the surgeon, patients often recover sooner, move on to additional treatments if needed, and get back to life quicker.

Other potential benefits of the da Vinci system for liver cancer patients are:

• Reduced pain
• Lower risk of infection or complications
• Less blood loss (fewer transfusions)
• Shorter hospital stays
• Less scarring
• Faster return to normal activities

Next Topic: Radiation Therapy for Liver Cancer