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Invited Critique
March 1, 2004

Long-term Results of Hepatic Resection for Hepatocellular Carcinoma Originating From the Noncirrhotic Liver—Invited Critique

Arch Surg. 2004;139(3):326. doi:10.1001/archsurg.139.3.326

Few areas of surgical oncology have been more controversial than the management of HCC. Based on promising results for liver transplantation reported in 1996 by Mazzaferro et al,1 organ allocation priorities assigned by the United Network for Organ Sharing have been dramatically altered such that patients with early-stage HCC (a single tumor up to 5 cm or up to 3 tumors with the largest being 3 cm) usually are able to undergo transplantation within 3 to 6 months of listing. More than 20% of all liver transplantations performed in the United States have HCC as the primary indication for transplantation. However, these exception criteria apply only to patients with established cirrhosis. Liver resection is still considered the standard approach for patients with HCC without cirrhosis.