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Invited Critique
October 19, 2009

HBV and HCC: Comment on “Role of Hepatitis B Virus Infection in the Prognosis After Hepatectomy for Hepatocellular Carcinomain Patients With Cirrhosis: A Western Dual-Center Experience”

Arch Surg. 2009;144(10):913. doi:10.1001/archsurg.2009.98

The surgical management of HCC in the cirrhotic patient remains a tremendous challenge, despite an array of treatment options including hepatic resection, ablative techniques, and liver transplantation. Although not without controversy, most regard resection as the treatment option of choice for solitary, relatively small, resectable lesions in those cirrhotic patients with preserved liver function. Unfortunately, HCC recurrence is common and often affects overall survival. Thus, it is important to determine those factors that predict HCC recurrence for 2 reasons: first, to identify that population most likely to benefit from traditional resection and, second, to direct those at greatest risk for recurrence toward alternate modalities.