Roles of surgery in the multidisciplinary treatment of hepatocellular carcinoma        LAI ECH, LAU SHY, LAU WY. Faculty of Medicine, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, P.R. China
Corresponding author：LAU WY，E-mail：josephlau@cuhk.edu.hk
Abstract    Liver resection is still the best treatment for hepatocellular carcinoma (HCC) aiming at cure. The important roles of surgery in the multidisciplinary treatment of HCC have increasingly been recognized. They include 3 aspects as following (1) neoadjuvant/adjuvant therapy to reduce the incidence of postoperative tumour recurrence or metastases for resectable HCC; (2) tumour downstaging followed by salvage liver resection for initially unresectable HCC; (3) adjuvant therapy for patients with HCC waiting for liver transplantation to control the rate of tumour growth and to prolong the waiting time for a donor liver to become available. There are limitations on the data from published medical literature on multidisciplinary treatment of HCC. All the reports are small in sample sizes and they are non-randomized studies. Thus, there is not enough medical evidence for clinical practice to be based on. There is an urgent need for high quality randomized studies with prolonged follow-up to be carried out. Until that time, clinicians can only base on the limited available medical evidence to decide on the best treatment for their patients. Any new treatment for HCC should now be evaluated properly with a well-designed clinical study. Future clinical studies on HCC should center on multidisciplinary treatment to improve on the results of surgery, on procedures to increase on tumour resectability, and on measures to reduce postoperative tumour recurrence or metastases.