What is a surgical option for a small solitary HCC not near major vessels?

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Removal of a small solitary HCC when liver reserve is good and enough healthy liver will remain after surgery is the main surgical approach with curative potential. The tumor’s small size, solitary nature, and location away from major vessels make it feasible to excise with clear margins while preserving most of the liver. The key requirement is an adequate future liver remnant and good baseline liver function, so the remaining liver can sustain metabolism and regeneration after resection. In practice, this can be done as anatomic resection (removing a hepatic segment or sections along the portal territories) or nonanatomic resection (wedge or limited resection) depending on the tumor’s exact location and the goal of preserving liver volume.

This option is favored over transplantation when the liver is otherwise healthy or only minimally diseased, because transplantation is reserved for patients with significant underlying liver dysfunction or multifocal disease where resection wouldn’t achieve clear margins or adequate hepatic function. Chemotherapy alone or palliative care do not offer a curative route for a localized tumor in a patient with good liver reserve, making surgical resection the best option in this scenario.