The Johns Hopkins University School of Public Health

Surgeon's Therapeutic Decisions in Early Hepatocellular Carcinoma

The surgical treatment of early hepatocellular carcinoma (HCC) is a matter of significant debate and little consensus. Most data indicate that liver transplantation for eligible patients provides long-term survival that is superior to that obtained with any other therapy. However, donor livers are a scarce commodity, and a significant proportion of patients will either die while waiting for a transplant or, more commonly, develop progression of disease that renders them ineligible for a transplant. As such, some surgeons advocate more readily available forms of surgical therapy (liver resection or radiofrequency ablation) as the initial course of treatment. No data exist on how surgeons make these choices. Patient and tumor factors likely play a role, but characteristics of the surgeons and hospitals themselves may also influence decision-making. This survey aims to elucidate factors that impact surgeons� therapeutic decisions in early HCC.