الفهرس 
Review of literature
Epidemiology of hepatocellular carcinomaOnly 14 pages are availabe for public view
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Abstract
HCC is the fifth most common cancer in the world, and it is associated with LC in approximately 60% – 90% of cases. Such patients often have a narrow range of treatment options. LR is widely accepted as a potentially curative treatment for patients with HCC. However, LR for cancer complicated by cirrhosis is not without risks. Laparoscopic surgery for liver procedures has been slow to develop. Initially introduced for staging procedures, it has now been implemented for uncomplicated LRs in HCC. The dissemination of laparoscopic liver surgery for HCC has been considerably restrained compared with other minimally invasive procedures. In many circumstances patients are unable to tolerate complete resection due to extensive tumor burden or underlying liver disease. In these circumstances ablative techniques can be used. Laparoscopic thermal ablative methods could provide an alternative to LLR in some patients. As such, it remains unclear whether laparoscopic surgery is of benefit to patients with HCC. Aim of Work: To evaluate the role of laparoscopy in the staging and treatment of HCC patients in a tertiary high volume center. Patients and Methods: We retrospectively reviewed the data for all patients who underwent either laparoscopic liver surgery for HCC at Seoul National University Bundang Hospital, Seoul National University, Korea during the period between July 2004 and July 2014.Results: During the study period 274 cases underwent different laparoscopic liver procedures for HCC. 231 cases underwent LLR, 19 cases underwent combined LLR and laparoscopic RFA, and 24 cases underwent laparoscopic RFA alone. In LLR group, the median hospital stay was 7 days. 40 cases (16%) had postoperative morbidity, and 2 cases (0.8%) had early postoperative mortality. The 1, 3, 5 years OS rates were 93.4%, 87.3%, 81.8% respectively. The 1, 3, 5 years DFS rates were 72.8%, 51.3%, 43.8% respectively. In LRFA, 3 cases (6.7%) had postoperative morbidities, and there was no early postoperative mortality. The 1, 3, 5 years OS rates were 100%, 93.5%, 87.7% respectively. The 1, 3, 5 years DFS rates were 56.8%, 27.4%, 27.4% respectively.Conclusions: Laparoscopic liver surgery is safe and feasible option for the management of HCC patients, with comparable perioperative and long term oncological outcomes. Laparoscopic major hepatectomy can be performed safely, in experienced hands.