Surgical Management of Primary Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is among the most common malignancy and cause of can‐ cer related death worldwide, with a high prevalence in Asia and south Africa as well as an increasing incidence in the western country. Patients with liver cirrhosis are at highest risk of developing this malignant disease, and the majority of HCC patients will develop the dis‐ ease on the background of preexisting hepatitis virus infection. It is estimated 50–70% asso‐ ciated with hepatitis C virus in North America and Europe and 70% associated with hepatitis B virus in Asia and Africa [1], and the incidence of HCC is significantly higher in men than in women. However, surveillance programs for HCC in patients with cirrhosis and chronic hepatitis, and the advancement of diagnostic tools are likely to further increase the incidence of HCC and the detection of small lesions in the liver that prompted the pro‐ portion of patients diagnosed at a potentially curative stage of disease.