The Role of Surgery in the Management of Hepatitis related Hepatocellular Carcinoma: A Systematic Review

Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and its incidence is rapidly increasing. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the most common causes of HCC. Surgical interventions, such as hepatectomy, liver transplantation, and ablation techniques, are the most common treatment options for HCC, but their effectiveness is still controversial. In recent years, there has been an increasing interest in understanding the effectiveness of surgical interventions in the treatment of hepatitis-related HCC. However, the effectiveness of surgical interventions in the treatment of hepatitis-related HCC is still controversial due to the heterogeneity of HCC and the varying stages of disease progression. Study Design: Systematic review Aim: This systematic review aims to evaluate the current evidence on the effectiveness of surgical interventions in the treatment of hepatitis-related HCC. Methods: A systematic search was conducted using PubMed, Cochrane Library and EMBASE using the following keywords: ((hepatitis OR hepatitis B OR hepatitis C) AND (hepatocellular carcinoma OR liver cancer OR liver neoplasm OR liver tumor) AND (surgery OR surgical procedures, operative OR hepatectomy OR liver transplantation OR radiofrequency ablation OR ablation techniques)). The protocol of this review lies in accord with Preferred Reporting Items for Systematic Reviews & Meta-analyses (PRISMA). Inclusion criteria included articles of retrospective designs published in English language. Studies had to include patients with a confirmed diagnosis of hepatitis related hepatocellular carcinoma. The intervention in study had to surgical. Results: Two retrospective analysis studies met the inclusion criteria; One study reported a median follow-up period of 69 months. The sample included 1,692 patients; 149 patients had hepatocellular carcinoma (HCC) ≤ 4 cm & 1,543 had hepatitis B (HBV) related hepatocellular carcinoma. One study divided the patients into a younger group (65 years). The second study had patients within the age range of 29-83 years. One study involved the comparison of hepatectomy versus percutaneous ablation while the second study involved liver resection as a surgical intervention for the treatment of hepatitis related hepatocellular carcinoma. Conclusion: In conclusion, surgical interventions, including hepatectomy, liver transplantation, and ablation techniques are effective treatment options for hepatitis-related HCC. However, the effectiveness of these interventions depends on the stage of the disease, tumor characteristics, and the patient's overall health status. Hepatectomy remains the mainstay treatment option for resect able HCC, while liver transplantation is a viable option for patients with unresectable HCC and end-stage liver disease. Ablation techniques have shown promising results for small, unresectable tumors. However, there is a need for further research to establish the effectiveness of surgical interventions in the treatment of hepatitis-related HCC, especially in advanced stages of the disease. Clinicians should consider individual patient factors and tumor characteristics when deciding on the most appropriate treatment option for patients with hepatitis-related HCC