Surgery is the only way to cure primary liver cancer, so the goal of the diagnostic work-up is to discover if all the cancerous tissue can be removed. This is often not possible, either because the tumor has already spread beyond the liver or because the liver is too damaged and removal of liver tissue would leave a person without enough liver function to survive.
Chemotherapy and radiation therapy are occasionally helpful in relieving symptoms. Primary liver cancer may progress rapidly, but these and other measures can be taken to maintain the quality of life. Newer treatments, such as more effective chemotherapy or liver transplantation, may someday allow the surgical removal of cancers now felt to be inoperable.
Surgery Surgery can cure liver cancer if the entire tumor can be removed. The liver has two distinct
lobes—right and left—and a tumor confined to one lobe can often be removed even if the patient has cirrhosis of the liver. If cirrhosis is only minimally or not at all present, a tumor involving parts of both lobes of the liver can be removed with an extensive operation (trisegmentectomy). This surgery is potentially dangerous, however, and people with poor liver function may not survive it.
Liver transplantation may be considered for someone whose cancer has not yet spread and who cannot tolerate the removal of part of the liver because of underlying liver disease or the size of the tumor. So far, this approach has been beneficial only in people with the fibrolamellar variant. Even if patients with hepatocellular carcinoma have no evidence of metastases, the tumor almost always redevelops after transplantation, perhaps
