الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Summary
Liver Transplantation and Liver resection achieve the
best outcomes for Hepatocellular Carcinoma in wellselected
candidates (5-year survival of 60 to 70%) and
compete as the first option from an intention-to treat
perspective.
Conversely, there is no question in considering LT as
the best option for patients with liver function impairment
(Child-Pugh B-C patients) and early tumors or for patients
with multinodular small tumors (two or three nodules<3
cm). While resection is better for resectable Extra - Milan
tumors on mild Cirrhosis.
But the Early Hepatocellular Carcinoma with mild
cirrhosis is still debatable between Liver transplantation
and Liver resection.
Supporters of Liver Transplantation rely on the
survival rates which are higher and recurrence rates which
are lower in comparison to resection, also the fact that
Transplantation doesn’t only treat the HCC, but also the
underlying pathology that predisposed to the malignancy .5
years survival rates as high as 89 % can be achieved by
Liver transplantation.
Drawbacks of Liver transplantation include waiting
time, inavaliability of the living donor, which causes drop
outs which when considered in the intension to treat
analysis, the Overall survival decrease. Also postoperative
complications including post transplantation immunosuppression,
infections, Renal failure, Diabetes,
Hypertension, post transplantation malignancies.
Supporters of the Liver resection rely on the
feasibility of the procedure, uncomplicated and rapid
preoperative preparation, lower post operative morbidity
and mortality (towards 0% mortality) due to refinement of
patient selection and optimizing the surgical techniques and
postoperative management.
Recent studies have shown that transplantation
eligible patients who undergo resection achieve 5 year
survival rates of 70 % which is comparable to that of
Transplantation.
The main draw back of Resection is the recurrence
can be true recurrence or De-novo tumors, but even
recurrence, Transplantation remains an option for these
patients (Salvage Liver transplantation). With survival rates
comparable to those who undergo Primary Liver
transplantation .Salvage liver transplantation have the
advantage of sparing a donor for other patient who has no
other options than transplantation, also delaying the need
for immunosuppression therapy and its complications.