A 55-year-old man with a 5 cm hepatocellular carcinoma in segments VI/VII on a background of Child-Pugh A cirrhosis is referred for treatment. AFP is 320 ng/mL. He has a single lesion with no vascular invasion and no extrahepatic disease. The future liver remnant after resection is estimated at 38%. The preferred treatment is:
- A Trans-arterial chemoembolisation (TACE)
- B Liver transplantation (exceeds Milan criteria — not eligible)
- C Hepatic resection (right hepatectomy) ✓
- D Radiofrequency ablation
Correct answer: C. Hepatic resection (right hepatectomy)
Explanation
This patient meets criteria for curative surgical resection: single HCC, no vascular invasion, Child-Pugh A, and a future liver remnant of 38% (threshold is ≥25% for Child-Pugh A). The tumour exceeds Milan criteria (≤5 cm single) only marginally but is resectable; TACE is a bridge or alternative for unresectable disease. RFA is preferred for lesions ≤3 cm.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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