Mean age was 57.6 years. Hepatocellular carcinoma arising on noncirrhotic liver is not a rare occurrence. It is usually encountered at an advanced stage of the disease. Nonetheless, it remains extirpable in many cases with low postoperative mortality and long term results are better than those of resections for hepatocellular carcinoma on cirrhotic liver. There are two principal aspects to surgical treatment of hepatocellular carcinoma, hepatectomy and transplantation.
Transplantation is a treatment of the tumor and the underlying liver disease.
Resection is indicated if there is no bilobar diffusion or metastasis. In the long run, the causes of mortality after resection for hepatocellular carcinoma are mainly subsequent to tumor recurrence. Transplantation is a priori the best possible treatment for small sized hepatocellular carcinoma developing on a chronically ill liver. In addition, the risk of recurrence of the causal liver disease, particularly in case of hepatitis B and C infections, is high. Finally, even if the initial tumor is a unique small-sized lesion, the risk of recurrence is favored by the immunosuppression required for tolerance after liver transplantation.