Selection
Suitability depends on the number, size and distribution of lesions, relation to the hepatic veins and portal structures, the volume of liver that remains, and control of the primary tumour. Response to chemotherapy is an important indicator.
Techniques used
Parenchyma-sparing non-anatomical resections, segmentectomy or hemihepatectomy, with intraoperative ultrasound to define lesions. Ablation may be combined for deep small lesions, and staged or two-stage approaches are used where remnant volume is limited.
Sequencing with systemic therapy
Timing relative to chemotherapy and to resection of the primary is planned at the tumour board — simultaneous, liver-first or primary-first — based on which site poses the greater threat.
Common questions
- Does the liver grow back?
- The liver regenerates substantially within weeks, which is what makes major resection possible when the remnant is healthy and adequately perfused.
Related reading
This page is general education, reviewed by Dr. Ishaan Allahabadi, MCh Surgical Oncology (Edge Hill, UK) · MS Surgery · MBBS (Accredited by the Royal College of Surgeons of England). It is not a substitute for individual medical advice. Treatment decisions are made after reviewing your imaging and pathology, in a multidisciplinary tumour board.