Surgical removal of the tumor is associated with better cancer prognosis, but only 5–15% of patients are suitable for surgical resection due to the extent of disease or poor liver function.
Surgery is only considered if the entire tumor can be safely removed while preserving sufficient functional liver to maintain normal physiology.
Thus, preoperative imaging assessment is critical  to determine both the extent of HCC and to estimate the amount of residual liver remaining after surgery.
To maintain liver function, residual liver volume should exceed 25% of total liver volume in a noncirrhotic liver, greater than 40% in a cirrhotic liver.
Surgery on diseased or cirrhotic livers is generally associated with higher morbidity and mortality.
The overall recurrence rate after resection is 50-60%.
The Singapore Liver Cancer Recurrence  score can be used to estimate risk of recurrence after surgery.
Surgical removal of the tumor is associated with better cancer prognosis, but only 5–15% of patients are suitable for surgical resection due to the extent of disease or poor liver function. Surgery is only considered if the entire tumor can be safely removed while preserving sufficient functional liver to maintain normal physiology. Thus, preoperative imaging assessment is critical  to determine both the extent of HCC and to estimate the amount of residual liver remaining after surgery. To maintain liver function, residual liver volume should exceed 25% of total liver volume in a noncirrhotic liver, greater than 40% in a cirrhotic liver. Surgery on diseased or cirrhotic livers is generally associated with higher morbidity and mortality. The overall recurrence rate after resection is 50-60%. The Singapore Liver Cancer Recurrence  score can be used to estimate risk of recurrence after surgery.
Hepatocellular carcinoma