Hepatocellular Carcinoma (HCC) · Expert Surgical Management

Liver Cancer (HCC)

Hepatocellular carcinoma caught at an early stage can be cured. Dr. Srinivas offers the full spectrum — from resection to liver transplant — with a multidisciplinary team.

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About Hepatocellular Carcinoma

HCC is the most common primary liver cancer and the third-leading cause of cancer death worldwide. In India, it most often arises in patients with underlying cirrhosis from Hepatitis B, Hepatitis C, alcohol, or fatty liver disease.

Symptoms

Upper abdominal pain (right side)
Unintentional weight loss
Loss of appetite
Abdominal swelling (ascites)
Jaundice in advanced disease
Often discovered incidentally on surveillance ultrasound — no symptoms

Early detection saves lives. HCC detected < 2cm has 5-year survival >70% with resection or transplant. Regular HCC surveillance ultrasound every 6 months in all cirrhotic patients is critical.

Treatment Options for Liver Cancer

Treatment depends on tumour size, number, vascular invasion, liver function (Child-Pugh/MELD), and overall patient fitness.

Curative

Surgical Resection

Removal of the tumour-bearing liver segment. Best for single tumours in patients with preserved liver function. 5-year survival 40–70% for early HCC.

Anatomical segmentectomy for optimal margins
Laparoscopic / Robotic resection for suitable cases
ALPPS procedure for borderline liver remnant

Curative

Liver Transplant

The only treatment that cures both the cancer AND the underlying cirrhosis. Best option for HCC within Milan criteria (1 tumour ≤5cm or 3 tumours ≤3cm, no vascular invasion).

ZCCK / TRANSTAN listed for deceased donor organs
Living donor transplant to avoid waiting
5-year survival >70% for Milan criteria HCC

Locoregional

TACE / TARE

Trans-Arterial Chemoembolisation (TACE) or Radio-Embolisation (TARE) — used for intermediate-stage HCC or as a bridge to transplant/resection.

Locoregional

Ablation (RFA / MWA)

Radiofrequency ablation or microwave ablation for tumours ≤3cm in non-surgical candidates. Can be curative for very small, well-positioned tumours.

Systemic

Systemic Therapy

Sorafenib, Lenvatinib (first-line). Atezolizumab + Bevacizumab (IMbrave150). For advanced HCC not amenable to local treatment.