Surgery for liver cancer

Surgical interventional approaches include:

• Primary resection: This surgery removes cancerous lesions with techniques that minimize blood loss.
• Microwave ablation: This minimally invasive technique involves placement of a needle electrode directly into the tumor, which then uses microwaves to induce an ultra-high-speed alternating electric field to destroy tumor cells.
• Radiofrequency ablation: In this approach, imaging techniques such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) are used to help guide a needle electrode into a cancerous tumor. High-frequency electrical currents are then passed through the electrode, creating heat that destroys the abnormal cells.
• TACE (trans-arterial chemoembolization): This interventional radiology procedure is used in patients who cannot undergo tumor-removal surgery, and is used to manage symptoms and improve outcomes. TACE blocks the hepatic artery – the artery from which liver cancers derive their blood supply – and directs chemotherapy to the tumor site.
• Portal vein embolization: This procedure is designed to shrink part of the diseased liver and stimulate growth of the remaining healthy liver. It is used in some patients prior to surgery to avoid the possibility of liver failure occurring due to a small liver remnant.
• Radioisotope embolization: This interventional radiology procedure is for patients who do not respond to TACE. The procedure involves the injection into the hepatic artery of tiny beads called microspheres that are impregnated with Yttrim-90, a radioisotope. The microspheres block the blood vessels that supply the tumor and irradiate the tumor site.