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Annals of Surgical Oncology

, Volume 21, Issue 3, pp 971–978 | Cite as

Long-Term Outcomes and Prognostic Factors with Reductive Hepatectomy and Sequential Percutaneous Isolated Hepatic Perfusion for Multiple Bilobar Hepatocellular Carcinoma

  • Takumi Fukumoto
  • Masahiro Tominaga
  • Masahiro Kido
  • Atsushi Takebe
  • Motofumi Tanaka
  • Kaori Kuramitsu
  • Ippei Matsumoto
  • Tetsuo Ajiki
  • Yonson Ku
Hepatobiliary Tumors

Abstract

Background

Sorafenib is currently recommended as first-line therapy for patients with intermediate or advanced hepatocellular carcinoma (HCC) per Barcelona Clinic Liver Cancer staging. However, the median overall survival (OS) with sorafenib in these patients is 10.7 months with an overall response rate of 2 %. We retrospectively investigated the long-term outcomes and prognostic factors with reductive hepatectomy and sequential percutaneous isolated hepatic perfusion (PIHP) for refractory intermediate or advanced HCC.

Methods

A total of 68 patients who had intermediate or advanced stage HCC without extrahepatic metastases were scheduled for reductive hepatectomy plus PIHP. All patients underwent reductive hepatectomy and PIHP with mitomycin C 20–40 mg/m2 and/or doxorubicin 60–120 mg/m2 1–3 months after surgery (mean, 1.51 times/patient).

Results

The objective response rate of PIHP was 70.6 % (complete plus partial response). The median OS of all 68 patients was 25 months, and the 5-year OS rate was 27.6 %. Univariate and multivariate analyses indicated that tumor response to PIHP and normalization of serum des-γ-carboxy prothrombin concentrations after PIHP were independent prognostic factors for OS.

Conclusions

The median OS of the study population treated by reductive hepatectomy and sequential PIHP was 25 months. This treatment strategy can offer a possible curative treatment to patients with refractory intermediate and advanced HCC.

Keywords

Sorafenib Tace Remnant Liver Extrahepatic Metastasis Barcelona Clinic Liver Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This study was supported by the new Therapeutic Technology Development Program 2000 from the Japanese Ministry of Education (Y.K.). The authors thank Dr. Kenichi Yoshimura for his valuable advice regarding the statistical analyses.

Disclosure

The authors declare no conflicts of interest.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Takumi Fukumoto
    • 1
  • Masahiro Tominaga
    • 1
  • Masahiro Kido
    • 1
  • Atsushi Takebe
    • 1
  • Motofumi Tanaka
    • 1
  • Kaori Kuramitsu
    • 1
  • Ippei Matsumoto
    • 1
  • Tetsuo Ajiki
    • 1
  • Yonson Ku
    • 1
  1. 1.Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of MedicineKobe UniversityKobeJapan

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