People with liver cancer may have a partial hepatectomy, which is surgery to remove part of the liver that has cancer, or a liver transplant to remove the diseased liver and replace it with a healthy liver.

Liver surgery aims to remove liver cancer by removing part or all of the diseased liver.

This article looks at types of liver cancer surgery, who they may be suitable for, risks, and recovery.

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The goal of liver surgery is to cure liver cancer by removing a tumor or to successfully transplant a liver, by replacing a diseased liver with a healthy liver from a donor.

Liver surgery aims to remove all cancer from the liver, which may provide the best outlook for people with liver cancer.

People may require liver surgery if the liver cancer is too large to treat with other therapies, such as ablation or radiation.

A partial hepatectomy, or liver resection, is the removal of a section of the liver to remove the cancer but leave enough of the liver to keep good function.

A partial hepatectomy may be suitable for people with:

  • good liver function
  • liver cancer that only affects part of the liver
  • a single tumor that has not spread into blood vessels

Risks and side effects

Partial hepatectomy is a major surgery and may come with the following risks and side effects:

  • bleeding, due to a large amount of blood passing through the liver
  • infection
  • anesthesia complications
  • blood clots
  • pneumonia
  • new liver cancer

If people have tumors that surgery is not able to remove, or if liver cancer is too severe for partial removal of the liver, then a liver transplant may be a suitable option.

People may have a liver transplant if they have a small tumor that has not grown into surrounding blood vessels.

A liver transplant may restore proper liver function and reduce the risk of a new liver cancer forming.

People may have a liver transplant from a deceased or living donor.

Risks and side effects

A liver transplant is a major procedure and may have the following risks and side effects:

  • bleeding
  • infection
  • blood clots
  • anesthesia complications
  • rejection of the new liver

People receiving a liver transplant will need to take immunosuppressive drugs to prevent the body rejecting the new liver. These drugs can come with side effects, such as:

  • increased risk of infection, due to a suppressed immune system
  • risk of increased growth of any liver cancer outside of the liver
  • high blood pressure
  • high cholesterol
  • diabetes
  • weakened bones
  • weakened kidneys
  • new cancer forming

Before having a partial hepatectomy, people will need to have imaging scans, such as MRI, CT, and angiography, to find out if surgery will be able to remove the cancer.

If people are on the waiting list for a liver transplant from a deceased donor, they will need to get to the hospital as soon as they have been told they have a match.

If people are having a living donor transplant, they will be able to schedule their procedure with their donor around 4–6 weeks in advance.

People may need to remain in hospital for 5–10 days following a partial hepatectomy.

Doctors will monitor people for any complications, such as bleeding or infection. People may receive care in an intensive care unit before moving to a regular ward.

After people have undergone liver transplant surgery, they will remain in an intensive care unit for close monitoring. Healthcare professionals will carry out blood tests to check the new liver is functioning properly, as well as tests to check kidney, lungs, and heart health.

People will begin taking immunosuppressive medications to prevent the body from rejecting the new organ. A person may move into a regular area of the hospital before they are ready to go home.

Following a partial hepatectomy, people may find it challenging to carry out their usual activities, and may require help whilst they recover.

People will need to remain active but also get enough rest. They may be able to resume their normal activities 2–3 months after surgery.

The liver that remains in the body will regrow and may take a few months to return to its normal size. As the liver regrows, people may experience temporary jaundice, which is a yellowing of the whites of the eyes and the skin.

After a liver transplant, people may be able to return home 1–2 weeks following surgery. People may be able to return to their normal activities within a few months, but will need to follow advice from their doctor.

People will need to attend regular check-ups to ensure the new liver is functioning properly and there are no complications.

People who have had a liver transplant from a living donor may have a shorter recovery time than those with a liver transplant from a deceased donor.

According to the American Cancer Society, survival rates for liver cancer are higher in people who have surgery to remove the cancer, no matter which stage of cancer they have.

Survival rates after partial hepatectomy may depend on the stage of cancer, liver function, and whether people have cirrhosis.

The following statistics are from the Barcelona Clinic Liver Cancer (BCLC) system:

BCLC stageSurvival
0A person has a 5-year survival rate of 80–90% after a liver resection or radiofrequency ablation (RFA) for single tumors measuring 2 centimeters (cm) or less.
AA person has a 5-year survival rate of 50–70% after a liver resection or RFA.
BThe median survival is 16 months. This may increase to 40 months after a person undergoes transarterial chemoembolization treatment.
CThe median survival is 11–13 months with treatment, and 6–8 months with treatment.
DThe median survival is 3–4 months.

The ACS states that the 5-year survival rate for those with early-stage liver cancer after undergoing a live transplant is 60–70%.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the survival rates for people following liver transplant from a deceased donor are:

  • 86% at 1 year
  • 78% at 3 years
  • 72% at 5 years

The 20-year survival rate may be around 53%.

This data may not match current rates as treatments may improve over time and survival rates may also increase.

The success of a liver transplant and long-term outcomes also depends on each person’s individual health and circumstances.

Liver surgery is a treatment option for people with liver cancer. The aim of surgery is to remove the section of liver with cancer, or to remove the entire liver and replace with a healthy liver from a donor.

Both partial hepatectomy and liver transplant are major surgeries, and can come with risks such as bleeding or infection. Doctors will monitor people following surgery to check for any complications.

People will need to follow any instructions from their healthcare team following surgery, and take any medications as a doctor prescribes, in order to aid their recovery.