Surgery and other treatments for liver cancer

Liver cancer treatment has advanced significantly in recent years, with several effective options now available. The best approach depends on the type and stage of liver cancer, how well the liver is functioning and a person’s overall health. Surgery remains an important option for some patients, but it is not the only treatment, and many people benefit from non-surgical therapies either instead of or alongside an operation.

Understanding how surgery compares with other treatments can help patients make informed decisions with their specialist team.

When is surgery considered for liver cancer?

Surgery aims to remove the cancer completely and offers the best chance of long-term control or cure in carefully selected patients. It's usually considered when the cancer is confined to the liver and liver function is good.

There are two main surgical approaches. One involves removing part of the liver containing the tumour, known as liver resection. The other is liver transplantation, which replaces the diseased liver entirely and is suitable for a small group of patients who meet strict criteria.

Surgery isn't appropriate for everyone. Many people with liver cancer also have underlying liver disease, such as cirrhosis, which can limit how much liver tissue can be safely removed.

How does ablation compare with surgery?

Ablation is a minimally invasive treatment that destroys cancer cells using heat, cold or other energy sources, rather than removing them surgically. It is most effective for small tumours and is often used when surgery is not suitable due to liver function or general health.

Ablation may be performed through the skin using imaging guidance and usually involves a shorter recovery time than surgery. While it can provide excellent tumour control in selected cases, the risk of cancer recurrence may be higher than with surgery, particularly for larger or multiple tumours.

Chemotherapy and targeted treatments

Traditional chemotherapy has a limited role in primary liver cancer, but newer targeted drugs have improved outcomes for some patients. These treatments work by interfering with specific pathways that cancer cells use to grow and spread.

Targeted therapies are usually used when surgery or ablation is not possible, or when the cancer has spread beyond the liver. They do not cure liver cancer but can slow disease progression and help control symptoms.

Immunotherapy and newer approaches

Immunotherapy is an important development in liver cancer treatment. These medicines help the immune system recognise and attack cancer cells more effectively. In some patients, immunotherapy has led to meaningful improvements in survival and quality of life.

Immunotherapy may be used alone or in combination with other treatments, including targeted drugs. Research is ongoing into how it can be combined with surgery or ablation to improve outcomes further.

Comparing treatment approaches

Each treatment has a different role depending on the individual situation:

Surgery offers the best chance of long-term control in selected patients with early-stage disease
Ablation provides effective local treatment for small tumours when surgery is not suitable
Targeted therapy and chemotherapy help control advanced disease and slow progression
Immunotherapy harnesses the immune system and is increasingly used in advanced or recurrent cancer

Choosing the right treatment

Decisions about liver cancer treatment are usually made by a multidisciplinary team that includes liver surgeons, oncologists, hepatologists and radiologists. This ensures that all options are considered and treatment is tailored to the individual.

Factors such as tumour size and number, liver function, general health and personal preferences all play a role in determining the most appropriate approach.

Looking ahead

Treatment for liver cancer is becoming increasingly personalised. While surgery remains a key option for some patients, many people benefit from non-surgical treatments that can control the disease effectively and preserve quality of life.

If you’ve been diagnosed with liver cancer, a specialist assessment is essential to understand which treatments are suitable for you and how they may be combined to achieve the best possible outcome.