Preanesthetic assessment of the patient with hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a common cause of cancer-related death worldwide. The incidence of HCC in the United States has steadily increased over the last two decades. As such, a growing number of surgical candidates are afflicted with HCC. Advanced HCC causes destruction of normal functioning hepatic parenchyma eventually leading to a reduction in drug metabolism and clotting factor production, both of which can lead to anesthetic complications during surgery.