EN
1. Preoperative preparation |
2. Types of surgery |
3. Possible risks |
4. Postoperative period |
5. Prognosis of treatment |
6. Cost of treatment |
7. Patient testimonial |
Liver cancer is one of the most common cancers in the world and is the 4th most common cause of death from oncology. The tumours are divided into two categories: primary and secondary. Primary liver cancer develops from the tissue of the organ itself, whereas secondary cancer is the metastasis of cancer to the liver from another organ or tissue.
Surgery is the main method of treatment for liver cancer. However, the treatment plan will depend primarily on the stage of the cancer. Thus, if the tumour has not had time to spread beyond the focus, and the patient has no contraindications – surgery is appointed. If cancer metastases to the liver have been detected, the operation is carried out depending on the primary diagnosis. That is, in the case of metastatic liver cancer, surgery may not be performed if the primary cancer is at the last stage. In such a clinical picture, palliative treatment methods are used to treat symptoms.
Preoperative preparation
The first stage of preparation for surgery for liver cancer is a thorough diagnostic examination. Its purpose is to exclude contraindications to surgery for the patient, for example, liver failure. Instrumental and laboratory diagnostics are prescribed:
CT and MRI;
electrocardiography (ECG);
biochemical blood analysis (including coagulation test).
As with any other intervention, 2 weeks before the operation to remove liver cancer, the patient must adhere to several rules:
no alcohol consumption;
no blood thinners;
a specific diet;
no smoking;
management of concomitant diseases (jaundice);
detoxification of the body.
For 8 hours before surgery, the patient should refuse food and water, so as not to offset the effect of surgical anaesthesia. The patient is also prescribed a cleansing enema.
Types of liver cancer surgery and how they are performed
Liver resection | A traditional intervention in which the surgeon cuts out the tumour and surrounding tissue. Due to the organ’s ability to regenerate quickly, the removed lobe of the liver recovers within a few months. Surgery for liver cancer can be performed either through open access or laparoscopically.
Liver resection can be performed on patients with cirrhosis if they have at least 30% of the organ’s function left after surgery. The presence of multiple masses or a tumour that has infiltrated blood vessels is usually an indication for other treatments. |
Liver transplantation | Liver transplantation is only performed in the first two stages of cancer if there are no contraindications. Transplantation is only possible from a living related donor with a sufficient degree of compatibility. Both the affected part of the organ and the whole organ may be taken from the patient. Up to 50% of the liver is taken from the donor, depending on the physiological parameters. |
Radioembolisation of the tumour / SIRT method | The procedure involves injecting radioactive microgranules into the artery that feeds the tumour. The active substance yttrium-90, entering the organ together with the bloodstream, irradiates the tumour. |
Ablation | This is a bloodless method of cancer treatment through the destruction of malignant cells using radiofrequency or low-temperature exposure. It is used when there are contraindications to traditional intervention or in addition to other methods. |
On the day of surgery, the patient is given an enema and anaesthesia. Life functions during the surgical intervention are maintained with the help of special devices.
The operating field is disinfected, and the place of punctures is determined (most often the operation is performed using minimally invasive techniques that do not require large incisions).
The abdominal cavity is filled with a special gas, and an endoscope with a camera is inserted. The picture of what is happening is displayed on a screen.
In this way, the surgical team can monitor the smallest movements of the surgical instruments in real-time. After the resection (or ablation) is complete, sutures are placed.
In the case of a liver transplant, two teams of doctors work simultaneously with the donor and the recipient. Such an intervention lasts on average about 10 hours.
Possible risks and complications
Any surgery, even the most innocuous, carries a certain percentage of risk for the patient. The most effective way to protect yourself is to go to a reliable surgeon who has many years of experience in performing the procedure you are about to undergo. That said, patients and their loved ones should be aware of the possible risks associated with surgery:
Bleeding;
Blood clots;
Infections;
Complications related to anaesthesia;
Rejection of the new organ after transplantation.
Surgical treatment of liver cancer is a complex procedure. The surgeon is required to remove enough tissue affected by the cancer process to prevent recurrence. At the same time, enough of the organ must be left behind to allow recovery of function. Liver transplantation is an even more complex operation and requires the coordinated work of a large team of doctors.
Postoperative period
After surgery for liver cancer, the first day (or several days – depending on the severity of the intervention) the patient is in the intensive care unit. During this time, doctors monitor his or her condition, as there is a high risk of postoperative complications. However, performing the procedure in a foreign clinic significantly reduces the possibility of complications. For several weeks after the intervention, the patient should adhere to the diet prescribed by the doctor. It is also necessary to take anti-inflammatory drugs and painkillers. In the case of liver transplantation, the recipient is also prescribed immunosuppressors to avoid rejection of the organ.
The prognosis for life after surgery
No doctor can answer the question of how many people live after surgery for liver cancer. The patient’s life expectancy depends on many factors – the stage of the disease, the quality and timeliness of treatment, and the general physical condition. If timely intervention is performed at stages zero and one, the 5-year survival rate can reach from 53% to 89%, according to the American research institutes of Washington and Mallinckrodt.
Cost of liver cancer surgery
The cost of liver cancer surgery varies greatly depending on the method and clinic chosen. For example, liver resection in Turkish hospitals will cost starting from $10,000, and in Indian hospitals – from $7,000. Organ transplantation in India will cost $28,000 – $35,000, while in Turkey the price will be $50,000 – $60,000. German clinics perform operations for liver cancer starting from €17,000 and transplantation from €200,000. The price of liver cancer surgery in Israel starts from $21,000, and transplantation of an organ will cost $178,000 – $200,000.
| Country | Cost |
|---|---|
| Liver resection in Turkey | from $10,000-$15,000 |
| Liver resection in India | from $7,000-$9,000 |
| Liver cancer surgery in Germany | from €17,000 |
| Liver cancer surgery in Israel | from $21,000 |
| Country | Cost |
|---|---|
| Liver transplantation in Turkey | $50,000 — $60,000 |
| Liver transplantation in Israel | $28,000 — $35,000 |
| Liver transplantation in Germany | from €200,000 |
| Liver transplantation in Israel | $178,000 — $200,000 |
Patient testimonial about liver cancer surgery
Clinic: Medical Park
Procedure: Radiofrequency ablation
Patient’s age: 30 years old
Patient from: Kyiv
Anna: “My husband and I came to Turkey for diagnostics. The doctors diagnosed him with liver cancer and insisted on urgent surgery. They made radiofrequency ablation – this is when the tumour is destroyed by ultrasound. The usual surgical intervention was contraindicated for my husband because the doctors found out that he had liver failure. My husband was even glad that they would not cut him. We were amazed by Turkish doctors with their coordinated operative work. Don’t believe it when they tell you that medicine is bad in Turkey – everything is top-notch!”
Summary
Liver cancer is a malignant tumour that occurs in 7% of all patients with cancer. Tumours come in primary and secondary forms. Primary liver cancer develops from the tissue of the organ itself, while secondary cancer is cancer metastasising to the liver from another organ or tissue.
Surgery is the main method of treatment for this disease. However, the treatment plan depends primarily on the stage of the cancer.
There are the main methods of surgical interventions for liver cancer: organ resection, liver transplantation, radioembolisation and ablation.
With timely intervention at stages zero and one, the 5-year survival rate can reach from 53% to 89%.
The cost of surgery depends on the chosen country, method of surgery and doctor’s qualification. Tentatively, prices start at $7,000.
Sources:
- 1. World Journal of Clinical Cases: Effectiveness of surgical resection for complicated liver cancer and its influencing factors
- 2. Clinical and Molecular Hepatology: The latest global burden of liver cancer
- 3. World Journal of Clinical Cases: Surgical treatment for liver cancer
- 4. American Cancer Society: Surgery for Liver Cancer
- 5. World Cancer Research Fund International: Liver cancer statistics
- 6. World Surgery of Surgical Oncology: Hepatic resection provided long-term survival for patients with intermediate and advanced-stage resectable hepatocellular carcinoma
