If you’ve received a liver cancer diagnosis, your treatment options depend on several factors. Surgery is sometimes but not always the best treatment option.

Your doctor will stage your cancer treatment options into one of three categories:

  • potentially transplantable or operable (resectable) cancer
  • inoperable (unresectable) cancer that hasn’t spread
  • advanced cancer

Partial hepatectomy and liver transplant are the two main types of surgery used to treat liver cancer.

These procedures are typically used to treat some types of liver cancer in the early stages, before it has spread to surrounding blood vessels or other parts of the body.

Read on to learn about the potential benefits and risks of these operations.

Partial hepatectomy is a surgical procedure that removes part of the liver. Your surgeon’s goal is to remove all the liver tissue that’s affected by cancer. They’ll take out some surrounding healthy liver and may also remove nearby lymph nodes.

Only a few people with liver cancer qualify for this surgery. Your doctor may recommend partial hepatectomy if you have:

  • good overall liver function
  • a single liver tumor that hasn’t grown into surrounding blood vessels
  • good general health
  • cirrhosis (liver scarring) and your doctor estimates you’ll have at least 30 percent of your liver function once the tumor is removed

You’re probably not a good candidate for partial hepatectomy if you have:

  • poor overall liver function due to severe cirrhosis
  • multiple tumors in your liver
  • a tumor that can’t be safely removed due to its size or location
  • advanced cancer that has spread from your liver to surrounding blood vessels, lymph nodes, or other parts of your body
  • medical conditions that raise your risk of complications from surgery

To learn whether you’re a good candidate for partial hepatectomy, your doctor may order imaging tests such as a CT or MRI scan.

Your doctor may also assess your liver function by ordering blood tests and asking you about your symptoms.

Risks and side effects

Partial hepatectomy is major surgery. It poses the risk of serious side effects, including:

  • bile duct leaks
  • blood clots
  • bleeding
  • infection
  • reactions to anesthesia

Before you undergo partial hepatectomy, talk with your surgeon about the potential benefits and risks. They can explain what the recovery process will involve. They can also teach you how to recognize and manage potential complications.

If your doctor determines that it’s not possible to remove just the tumor, they may suggest a liver transplant. This surgery involves removing your liver and replacing it with a healthy liver from an organ donor.

Surgeons usually use a donor liver from someone who’s recently died. But sometimes they use a portion of healthy liver from someone who’s still alive, because the liver from a healthy donor can partially regenerate itself.

Your doctor may recommend a liver transplant if you have:

  • liver tumor(s) that can’t be removed through partial hepatectomy (although transplants are rarely used in people who do have resectable tumors)
  • small tumors that haven’t spread to nearby blood vessels
  • severe cirrhosis

A liver transplant may not be a good option for you if:

  • there are no suitable liver donors available
  • the cancer has spread from your liver to surrounding blood vessels, lymph nodes, or other parts of your body
  • you have medications or health conditions that raise your risk of complications

Before a liver transplant can be performed, a suitable liver donor must be found. The wait time for a donor may be long. Your doctor may recommend other treatments while you wait for a transplant.

Risks and side effects

A liver transplant is a major operation. It can cause serious side effects, including:

  • bile duct leaks
  • blood clots
  • bleeding
  • infection
  • reactions to anesthesia

Your immune system may also see the donor liver as a foreign invader it needs to attack. That means it’s possible that your body will reject the transplant.

Anti-rejection medications known as immunosuppressants can help stop your body from rejecting the donor liver.

Immunosuppressants reduce the number of white blood cells produced by your immune system to lower the odds that your body will reject the donor liver.

If you take an immunosuppressant, you may have higher risk of:

  • severe infections
  • weakened bones and osteoporosis
  • kidney damage
  • high blood pressure
  • high cholesterol
  • diabetes
  • anemia (low red blood cell count)
  • blood clotting problems

Your doctor will order regular blood tests to monitor for signs of liver rejection and check how your blood is clotting.

Your doctor can also teach you how to recognize potential signs and symptoms of liver rejection and other potential complications.

Your provider might recommend other liver cancer treatments after partial hepatectomy to reduce the risk of the cancer returning. Nonsurgical treatments may also be an option if surgery isn’t possible, or if cancer returns after surgery.

Nonsurgical liver cancer treatments include:

  • chemotherapy
  • targeted therapy
  • immunotherapy
  • radiation therapy
  • ablation therapy
  • embolization therapy

Talk with your doctor about the potential risks and benefits of any treatments they recommend.

Your outlook following partial hepatectomy or liver transplant depends on multiple factors, including:

  • your overall health
  • the type of surgery you have
  • the number, location, and size of tumors in your body
  • whether or not you develop complications from surgery

In some cases, partial hepatectomy or liver transplant cures liver cancer. It’s also possible for liver cancer to return after surgery.

For the best possible outcome, it’s important to follow your doctor’s instructions for follow-up care:

  • Attend your scheduled follow-up appointments.
  • Take your prescribed treatments.
  • Practice healthy lifestyle habits.

Let your provider know if you develop any new symptoms or changes in your health. In some cases, they may order tests to check for potential complications from treatment or if the cancer has returned or spread.

Depending on your condition and overall health, your treatment plan for liver cancer might include partial hepatectomy or liver transplant.

Your doctor can help you weigh the potential benefits and risks of surgery to determine whether it’s the right option for you.

Your treatment plan may also include additional therapies to help relieve symptoms of cancer or manage potential side effects from treatment.