Advances in the surgical treatment of liver cancer.

Liver resection is the standard curative treatment for liver cancer. Advances in surgical techniques over the last 30 years, including the preoperative assessment of the future liver remnant, have improved the safety of liver resection. In addition, advances in nonsurgical multidisciplinary treatment have increased the opportunities for tumor downstaging. Consequently, the indications for resection of more advanced liver cancer have expanded. Laparoscopic and robot-assisted liver resections have also gradually become more widespread. These techniques should be performed in stages, depending on the difficulty of the procedure. Advances in preoperative simulation and intraoperative navigation technology may have also lowered the threshold for their performance and may have promoted their widespread use. New insights and experiences gained from laparoscopic surgery may be applicable in open surgery. Liver transplantation, which is usually indicated for patients with poor liver function, has also become safer with advances in perioperative management. The indications for liver transplantation in liver cancer are also expanding. Although the coronavirus disease 2019 pandemic has forced the postponement of liver resection and transplantation procedures, liver surgeons should appropriately tailor the surgical plan to the individual patient as part of multidisciplinary treatment. This review may provide an entry point for future clinical research by identifying currently unresolved issues regarding liver cancer, and particularly hepatocellular carcinoma.

COVID-19 and liver surgery in France, Italy, Japan, and the United States: A report of a single topic conference of Eastern and Western Association for Liver Tumors (EWALT) 2021.

The Eastern and Western Association for Liver Tumors (EWALT) is an international association for clinical and basic scientists dedicated to worldwide study on hepatocellular carcinoma. A single topic conference of EWALT on "COVID-19 and Liver Surgery" was held online on April 23th, 2021. The presenters from France, Italy, Japan, and the United States, reported the current situation of COVID-19 in each country and the influence on the clinical practice and education in hepato-pancreato-biliary surgery. Here we would like to summarize the core of this single topic conference.