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<p>Complete tumor removal with negative margins (R0 resection) remains the central curative treatment approach in hepatobiliary oncology. Over the past decade, minimally invasive liver surgery and especially robotic platforms have moved from selected cases and into routine practice in many centers, with growing evidence that these approaches can reduce postoperative morbidity without compromising oncologic principles. At the same time, systemic and locoregional treatment is increasingly given before surgery, both to convert initially unresectable tumors into a&#xa0;resectable situation and to optimize outcomes in selected patients with resectable disease. Operative decision-making, however, is not driven by tumor biology alone: preserved hepatic reserve is equally critical. When the anticipated future liver remnant is inadequate, preoperative hypertrophy strategies such as portal vein embolization and, in selected settings, hepatic vein embolization can expand the surgical options and improve safety. Because modern care is frequently multimodal—sometimes extending to liver transplantation—and because the perioperative risk can be substantial, patients benefit most from evaluation and treatment in high-volume, multidisciplinary referral centers. For hepatocellular carcinoma in particular, both resection and transplantation are established curative therapies. This review highlights current trends in the field, with an emphasis on evolving multimodal treatment strategies and synthesizes the available contemporary evidence.</p>

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Resektion und Transplantation – Chirurgie des hepatozellulären Karzinoms und des Cholangiokarzinoms

  • 期刊论文

  • 发表日期：

    2026年2月19日

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  • Hans-Michael Tautenhahn,
  • Ulf P. Neumann,
  • Daniel Seehofer

摘要

Complete tumor removal with negative margins (R0 resection) remains the central curative treatment approach in hepatobiliary oncology. Over the past decade, minimally invasive liver surgery and especially robotic platforms have moved from selected cases and into routine practice in many centers, with growing evidence that these approaches can reduce postoperative morbidity without compromising oncologic principles. At the same time, systemic and locoregional treatment is increasingly given before surgery, both to convert initially unresectable tumors into a resectable situation and to optimize outcomes in selected patients with resectable disease. Operative decision-making, however, is not driven by tumor biology alone: preserved hepatic reserve is equally critical. When the anticipated future liver remnant is inadequate, preoperative hypertrophy strategies such as portal vein embolization and, in selected settings, hepatic vein embolization can expand the surgical options and improve safety. Because modern care is frequently multimodal—sometimes extending to liver transplantation—and because the perioperative risk can be substantial, patients benefit most from evaluation and treatment in high-volume, multidisciplinary referral centers. For hepatocellular carcinoma in particular, both resection and transplantation are established curative therapies. This review highlights current trends in the field, with an emphasis on evolving multimodal treatment strategies and synthesizes the available contemporary evidence.