Perihilar cholangiocarcinoma, a rare and aggressive tumor, can develop in the bile ducts at the junction of the right and left hepatic ducts. Successful treatment with of surgical excision and/or transplantation has significantly improved the management of the disease, leading to increased survival rates and better quality of life for patients. Nonetheless, challenges persist, including limited therapy options for advanced-stage disease, potential risks, and a shortage of donor organs. For early-stage disease, surgical resection, usually right hepatectomy, is the preferred treatment, while transplantation is indicated for non-resectable cases. Liver transplantation offers prolonged survival for certain individuals; however, it requires lifelong immunosuppression and carries the risk of recurrence. The choice between resection and transplantation depends on various factors, including disease stage, patient health, and the availability of a donor organ. For patients diagnosed with perihilar cholangiocarcinoma, implementing an interdisciplinary approach is crucial for optimizing therapeutic efficacy.

Purpose: Treatment options for hepatocellular carcinoma (HCC) vary according to known guidelines among liver resection (LR), liver transplantation (LT), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). This study aimed to compare the outcomes of initial treatment for patients with resectable HCC within Milan criteria (MC) via nationwide data. Methods: Patients with resectable HCC (Child-Pugh class A; platelet count, ≥100,000/μL) within MC from the Korean Liver Cancer Association databank were analyzed, retrospectively. Outcomes according to initial treatment and subgroups according to tumor size and number were analyzed. Overall survival (OS) rates after initial treatment were compared. Results: A total of 3,241 patients who underwent LR (n = 1,371), LT (n = 12), RFA (n = 679), or TACE (n = 1,179) were included. The 5-year OS rates differed significantly between the groups (P < 0.05), except for LT (LR, 84.9%; LT, 82.5%;RFA, 76.2%; and TACE, 59.9%). For patients with a single tumor of any size, the 5-year OS rates of the LR group were significantly higher than RFA and TACE groups. For patients with multiple tumors, the 5-year OS rates were 78.2%, 100%, 74.3%, and 53.0% for the LR, LT, RFA, and TACE groups, respectively, but without significant difference between LR and RFA (P = 0.86). Conclusion For resectable HCC within MC, the LR had the highest OS rate for a single tumor of any size. LR and RFA showed no significant differences in OS rate for multiple tumors. LR has a much more optimistic outlook for HCC within MC.

Perihilar cholangiocarcinoma, a rare and aggressive tumor, can develop in the bile ducts at the junction of the right and left hepatic ducts. Successful treatment with of surgical excision and/or transplantation has significantly improved the management of the disease, leading to increased survival rates and better quality of life for patients. Nonetheless, challenges persist, including limited therapy options for advanced-stage disease, potential risks, and a shortage of donor organs. For early-stage disease, surgical resection, usually right hepatectomy, is the preferred treatment, while transplantation is indicated for non-resectable cases. Liver transplantation offers prolonged survival for certain individuals; however, it requires lifelong immunosuppression and carries the risk of recurrence. The choice between resection and transplantation depends on various factors, including disease stage, patient health, and the availability of a donor organ. For patients diagnosed with perihilar cholangiocarcinoma, implementing an interdisciplinary approach is crucial for optimizing therapeutic efficacy.

Perihilar cholangiocarcinoma, a rare and aggressive tumor, can develop in the bile ducts at the junction of the right and left hepatic ducts. Successful treatment with of surgical excision and/or transplantation has significantly improved the management of the disease, leading to increased survival rates and better quality of life for patients. Nonetheless, challenges persist, including limited therapy options for advanced-stage disease, potential risks, and a shortage of donor organs. For early-stage disease, surgical resection, usually right hepatectomy, is the preferred treatment, while transplantation is indicated for non-resectable cases. Liver transplantation offers prolonged survival for certain individuals; however, it requires lifelong immunosuppression and carries the risk of recurrence. The choice between resection and transplantation depends on various factors, including disease stage, patient health, and the availability of a donor organ. For patients diagnosed with perihilar cholangiocarcinoma, implementing an interdisciplinary approach is crucial for optimizing therapeutic efficacy.

Purpose: Treatment options for hepatocellular carcinoma (HCC) vary according to known guidelines among liver resection (LR), liver transplantation (LT), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). This study aimed to compare the outcomes of initial treatment for patients with resectable HCC within Milan criteria (MC) via nationwide data. Methods: Patients with resectable HCC (Child-Pugh class A; platelet count, ≥100,000/μL) within MC from the Korean Liver Cancer Association databank were analyzed, retrospectively. Outcomes according to initial treatment and subgroups according to tumor size and number were analyzed. Overall survival (OS) rates after initial treatment were compared. Results: A total of 3,241 patients who underwent LR (n = 1,371), LT (n = 12), RFA (n = 679), or TACE (n = 1,179) were included. The 5-year OS rates differed significantly between the groups (P < 0.05), except for LT (LR, 84.9%; LT, 82.5%;RFA, 76.2%; and TACE, 59.9%). For patients with a single tumor of any size, the 5-year OS rates of the LR group were significantly higher than RFA and TACE groups. For patients with multiple tumors, the 5-year OS rates were 78.2%, 100%, 74.3%, and 53.0% for the LR, LT, RFA, and TACE groups, respectively, but without significant difference between LR and RFA (P = 0.86). Conclusion For resectable HCC within MC, the LR had the highest OS rate for a single tumor of any size. LR and RFA showed no significant differences in OS rate for multiple tumors. LR has a much more optimistic outlook for HCC within MC.

Perihilar cholangiocarcinoma, a rare and aggressive tumor, can develop in the bile ducts at the junction of the right and left hepatic ducts. Successful treatment with of surgical excision and/or transplantation has significantly improved the management of the disease, leading to increased survival rates and better quality of life for patients. Nonetheless, challenges persist, including limited therapy options for advanced-stage disease, potential risks, and a shortage of donor organs. For early-stage disease, surgical resection, usually right hepatectomy, is the preferred treatment, while transplantation is indicated for non-resectable cases. Liver transplantation offers prolonged survival for certain individuals; however, it requires lifelong immunosuppression and carries the risk of recurrence. The choice between resection and transplantation depends on various factors, including disease stage, patient health, and the availability of a donor organ. For patients diagnosed with perihilar cholangiocarcinoma, implementing an interdisciplinary approach is crucial for optimizing therapeutic efficacy.

Purpose: Treatment options for hepatocellular carcinoma (HCC) vary according to known guidelines among liver resection (LR), liver transplantation (LT), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). This study aimed to compare the outcomes of initial treatment for patients with resectable HCC within Milan criteria (MC) via nationwide data. Methods: Patients with resectable HCC (Child-Pugh class A; platelet count, ≥100,000/μL) within MC from the Korean Liver Cancer Association databank were analyzed, retrospectively. Outcomes according to initial treatment and subgroups according to tumor size and number were analyzed. Overall survival (OS) rates after initial treatment were compared. Results: A total of 3,241 patients who underwent LR (n = 1,371), LT (n = 12), RFA (n = 679), or TACE (n = 1,179) were included. The 5-year OS rates differed significantly between the groups (P < 0.05), except for LT (LR, 84.9%; LT, 82.5%;RFA, 76.2%; and TACE, 59.9%). For patients with a single tumor of any size, the 5-year OS rates of the LR group were significantly higher than RFA and TACE groups. For patients with multiple tumors, the 5-year OS rates were 78.2%, 100%, 74.3%, and 53.0% for the LR, LT, RFA, and TACE groups, respectively, but without significant difference between LR and RFA (P = 0.86). Conclusion For resectable HCC within MC, the LR had the highest OS rate for a single tumor of any size. LR and RFA showed no significant differences in OS rate for multiple tumors. LR has a much more optimistic outlook for HCC within MC.