Liver cancer can be a daunting diagnosis—not only for patients but also for their loved ones. The journey ahead often involves many decisions, with surgery frequently playing a central role in treatment.
Surgery is the standard care for liver cancer, especially when the tumour is localised and has not spread beyond the liver.
This article will detail the types of liver cancer surgery in Singapore, what outcomes to expect after surgery, and the treatment options available if surgery isn’t possible due to late-stage diagnosis.
Surgical Options for Liver Cancer in Singapore
Liver Resection (Partial Hepatectomy)
A liver resection, or partial hepatectomy, involves removing the portion of the liver containing the tumour:
This operation is typically considered when the cancer is localised, as unlike many organs (like the stomach and colon) where entire removal is possible, complete liver removal is not possible.
As such, a liver resection is only considered when complete removal of the cancer is feasible and enough healthy liver tissue remains.
One of the key considerations is whether the patient’s remaining liver is strong enough to support recovery:
Patients with underlying liver damage, such as cirrhosis, may not be suitable candidates for resection, even if imaging suggests the tumour is operable. In such cases, other treatments like transplantation may be explored instead.
While imaging studies such as CT scans or MRIs help assess tumour resectability, sometimes the true extent of the cancer is only discovered during surgery. If it turns out that the tumour has spread more extensively than expected, the planned resection may not proceed.
Liver Transplantation
In cases where resection is not possible either due to multiple cancer nodules, recurring cancer or because the liver is too damaged, a liver transplant may be recommended. This involves replacing the diseased liver with a healthy donor liver.
Donor livers come from deceased donors or living donors, where a healthy individual, often a relative or close friend, may donate a portion of their liver.
Before moving forward with transplantation, patients undergo a thorough series of tests and medical evaluations to determine if they are fit for the procedure. After a successful transplant, lifelong immunosuppression is necessary to prevent the body from rejecting the new liver.
Are there risks of liver cancer surgery?
Like all major surgeries, liver operations carry risks. These include:
- Bleeding, due to the liver’s high vascularity
- Infection, particularly at the surgical site or within the abdomen.
- Bile leakage, which may cause abdominal infection or require drainage.
- Liver failure, especially if insufficient healthy tissue remains.
These complications are around 30-35%, though most can be managed with an experienced surgeon and with a laparoscopic liver resection.
A laparoscopic liver resection not only has lower complications compared to an open surgery but decreased postoperative pain, less intraoperative blood loss, reduced recovery time, and shorter hospital stay.
On average, patients can expect a hospital stay of 5 to 10 days. The initial recovery phase usually takes about 2 to 4 weeks, while full recovery may take 6 to 8 weeks, or longer if the procedure was more complex.
For liver transplant patients, lifelong follow-up is essential. This includes regular scans and blood tests to monitor liver function and detect any early signs of cancer recurrence or organ rejection.
Can surgery cure liver cancer?
When liver cancer is caught early and treated surgically—either through resection or transplantation—there is a significant chance of long-term survival and even cure.
Liver resection for small, localised tumours offers 5-year survival rates over 40%, depending on the tumour biology and liver function.
Liver transplantation offers 5-year survival rates of 60–70% or higher, with lower recurrence risk.
Concerned about a diagnosis?
Consult our specialist for treatment guidance or a second opinion.
Dr Thng Yongxian
Hepatopancreatobiliary & General Surgeon
Dual Fellowship-Trained Specialist
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS
Dr Thng Yongxian
Hepatopancreatobiliary & General Surgeon
Dual Fellowship-Trained Specialist
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS
Summary of liver cancer surgery costs
Treatment for liver cancer will depend on the specifics of each patient’s cancer and surgeon’s fee. But in general, these are the numbers you can expect;
- Liver Transplant, Donation (Live Donor) S$18,800 – S$26,500.
- Liver Transplant, Recipient: S$22,400 – S$33,600.
- Liver, Various Lesions, Lobectomy (3 – 4 Segments): S$17,400 – S$24,800.
Take note that these figures exclude hospitalisation fees, which average around:
- Private: $3,152
- Public (Ward A, unsubsidised): $1,711
- Public (Ward C, subsidised): $544
MediSave can be used to help cover part of the costs for the surgery; however the amount you can withdraw depends on several factors such your surgical procedure, ward class, and whether additional treatments are required during your stay.
Because each case is different and MediSave limits vary depending on the specifics of your treatment plan, we’re unable to provide exact figures in this article.
For a more accurate estimate, please get in touch with our staff. We’ll be happy to check your eligibility and provide a personalised breakdown of the potential MediSave coverage based on your treatment and hospital plan.
What if surgery is not an option? Non-surgical treatment for liver cancer
Unfortunately, not all liver cancer patients are suitable candidates for surgery. This could be due to the tumour being too widespread, the presence of cancer outside the liver, or poor liver function that increases the risk of surgery. But even in such cases, treatment options remain available, and hope is not lost.
Some non-surgical treatment options include;
Ablation Therapies
These are minimally invasive procedures that use heat (radiofrequency ablation or microwave ablation) or alcohol injection to destroy cancer cells. They are usually used for small tumours or for patients who cannot tolerate surgery.
Transarterial Chemoembolisation (TACE)
TACE delivers chemotherapy directly into the blood vessels feeding the liver tumour, while also blocking the blood supply to the cancer. This is often used in patients with intermediate-stage liver cancer to shrink or control tumour growth.
Systemic Therapy
For advanced liver cancer, targeted therapies (like Sorafenib or Lenvatinib) or immunotherapy drugs (like checkpoint inhibitors) may be prescribed. These aim to slow tumour progression and improve quality of life, even if a cure is not possible.
Radiation Therapy
Stereotactic body radiotherapy (SBRT) or proton beam therapy can be used in select patients to target liver tumours, especially when surgery or ablation isn’t feasible.
Regardless of whether you undergo surgery or alternative therapies, ongoing care even after treatment is essential. This includes regular imaging to monitor for recurrence, blood tests to assess liver function and tumour markers and lifestyle modifications (e.g. avoiding alcohol, eating a liver-friendly diet).
Final Thoughts
Receiving a liver cancer diagnosis can be deeply unsettling—not just because of the news itself, but also because of the questions that come next. With so many treatment options and medical terms to navigate, it’s completely normal to feel overwhelmed or unsure about what to do next.
If you or a loved one has been diagnosed with liver cancer, don’t hesitate to seek a second opinion or explore treatment options with a liver specialist. Early diagnosis and timely intervention can significantly improve outcomes and give you the best fighting chance.
If you have any questions for me, feel free to write to me.
This article is part of Dr. Thng’s ongoing efforts to make educational content on liver health accessible to everyone. For more articles and resources on related topics, click here.
Dr Thng Yongxian
Senior Consultant HEPATOPANCREATOBILIARY & GENERAL SURGEON
Dr Thng Yongxian is a fellowship-trained surgeon and surgical oncologist with a focus on minimally invasive liver and pancreatic surgery. He brings extensive surgical experience in managing routine and complex conditions, including cancers of the hepatopancreatobiliary system.
- Bachelor of Medicine & Bachelor of Surgery (MBBS), National University of Singapore
- Membership of the Royal College of Surgeons (MRCS), Ireland
- Master of Medicine (MMed), General Surgery, Singapore
- Fellow of the Royal College of Surgeons (FRCS), Edinburgh
- Fellow of the Academy of Medicine (FAMS), Singapore
Languages Spoken: English, Mandarin, Cantonese, Hokkien, Teochew
Dr Thng Yongxian is a hepatopancreatobiliary (HPB) and general surgeon with subspecialty expertise in minimally invasive liver and pancreatic surgery. He practises at Mount Elizabeth (Orchard and Novena), Parkway East, Mount Alvernia Hospital and Gleneagles Hospital.
Previously serving as Consultant and Clinical Lead for the HPB Division at National University Health System (NUHS), Dr Thng pioneered the use of laparoscopic techniques for complex HPB procedures — enabling up to 80% of such surgeries to be performed minimally invasively under his leadership.
Dr Thng received his medical degree from the National University of Singapore and underwent advanced surgical training locally and internationally, including a clinical fellowship at Seoul National University Hospital in South Korea. He is a Fellow of the Royal College of Surgeons (Edinburgh) and the Academy of Medicine, Singapore.
Committed to delivering value-driven care, Dr Thng has held leadership roles in national initiatives to improve surgical outcomes and reduce patient costs. He also actively contributes to research and education, with international presentations, published work on complex liver resections, and experience training the next generation of surgeons.
References:
- Ishii, M., Mizuguchi, T., Harada, K., Ota, S., Meguro, M., Ueki, T., Nishidate, T., Okita, K., & Hirata, K. (2014). Comprehensive review of post-liver resection surgical complications and a new universal classification and grading system. World journal of hepatology, 6(10), 745–751. https://doi.org/10.4254/wjh.v6.i10.745
- Slakey, D. P., Simms, E., Drew, B., Yazdi, F., & Roberts, B. (2013). Complications of liver resection: laparoscopic versus open procedures. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 17(1), 46–55. https://doi.org/10.4293/108680812X13517013317716
- https://www.singhealth.com.sg/patient-care/conditions-treatments/liver-cancer
- https://www.cancer.org/cancer/types/liver-cancer/treating/surgery.html
- https://www.health365.sg/cost-of-liver-cancer-screen-treatment-in-singapore/