Liver resection for hepatocellular carcinoma with vascular invasion: Current insights and future perspectives

Abstract The role of liver resection (LR) in patients with hepatocellular carcinoma (HCC) with vascular invasion (VI) remains controversial due to the inconsistent survival outcomes reported across different studies. In recent years, with breakthroughs in targeted therapy and immunotherapy for the treatment of advanced HCC, attempts to improve the surgical treatment outcomes of HCC with VI through neoadjuvant or adjuvant therapy have become an important research focus. This article reviewed the relevant literature published in recent years and systematically analyzed studies regarding LR in the treatment of HCC patients with VI and their outcomes. Based on previous studies, VI exhibits systemic characteristics. Despite the use of various surgical methods to resect the tumor or attempt to improve treatment efficacy by expanding the extent of LR, improving the surgical outcomes of HCC with VI has been problematic. Scientifically determining the extent of LR while fully preserving liver function, combining local and systemic therapies before and after surgery, and exploring more effective adjuvant treatment methods are important for further improving the efficacy of LR for HCC with VI.