Is hepatic resection a curative option for a tumor in the right hepatic lobe (Right Hepatic Lobe, RHL)?

From the Guidelines

Hepatic resection can be a curative option for a tumor in the right hepatic lobe, provided the patient has a solitary tumor with no evidence of gross vascular invasion and adequate liver function. This is based on the most recent guidelines from the National Comprehensive Cancer Network (NCCN) [ 1 ]. The decision to proceed with hepatic resection depends on several factors, including:

• Tumor characteristics, such as size and location
• Underlying liver disease, such as cirrhosis
• Functional liver reserve, which can be assessed through imaging studies and liver function tests
• Patient's overall health status, including their ability to tolerate major surgery

According to the NCCN guidelines [ 1 ], partial hepatectomy is a potentially curative therapy for patients with a solitary tumor of any size with no evidence of gross vascular invasion. The guidelines also note that partial hepatectomy for well-selected patients with hepatocellular carcinoma (HCC) can be performed with low operative morbidity and mortality (5%) [ 1 ].

The liver's remarkable regenerative capacity allows for removal of up to 70-75% of liver tissue in patients with normal liver function [ 1 ]. Preoperative assessment typically includes imaging studies (CT, MRI), liver function tests, and sometimes portal vein embolization to induce hypertrophy of the future liver remnant [ 1 ]. While resection offers the best chance for cure in appropriate candidates, alternative treatments like ablation, transarterial chemoembolization, or transplantation may be considered for patients who are not surgical candidates [ 1 ].

Recovery after hepatic resection typically requires 4-8 weeks, with close monitoring for complications such as bleeding, infection, or liver failure [ 1 ]. The 5-year survival rates for patients undergoing liver resection for HCC can be as high as 50% [ 1 ], making hepatic resection a viable option for patients with tumors in the right hepatic lobe.

From the Research

Hepatic Resection as a Curative Option

Hepatic resection can be a curative option for tumors in the right hepatic lobe, depending on various factors such as tumor size, location, and the patient's overall health.

• The decision to perform hepatic resection is based on the tumor's characteristics, the patient's liver function, and their overall health 2.
• Studies have shown that hepatic resection can be an effective treatment for primary and secondary liver tumors, including those in the right hepatic lobe 3.
• The success of hepatic resection depends on various factors, including the tumor's size, location, and the presence of vascular invasion 4.

Factors Influencing Curative Outcomes

Several factors can influence the curative outcome of hepatic resection for tumors in the right hepatic lobe, including:

• Tumor size: Larger tumors may be more difficult to resect and may have a higher risk of recurrence 4.
• Tumor location: Tumors located in the right hepatic lobe may be more accessible for resection than those in other locations 2.
• Liver function: Patients with poor liver function may not be candidates for hepatic resection 2.
• Vascular invasion: The presence of vascular invasion can increase the risk of recurrence and decrease the chances of a curative outcome 4.

Alternative Treatment Options

In some cases, alternative treatment options may be considered for tumors in the right hepatic lobe, such as:

• Radiofrequency thermal ablation: This minimally invasive procedure can be effective for treating small tumors 5.
• Chemotherapy and radiation therapy: These treatments may be used in combination with hepatic resection or as alternative treatments for patients who are not candidates for surgery 5.