Liver Resection in Advanced Hepatocellular Carcinoma
HCC is one of the most common cancers world-wide. The prognosis of untreated patients is universally dismal.1 Surgical resection is the treatment of choice and offers the only chance of prolonged survival.2 Yet our best surgical attempts are often frustrated by advanced disease and coexistent cirrhosis that renders the patient non-resectable. The results of orthotopic liver transplantation (OLT) in patients with advanced HCC have been poor. Likewise, chemotherapy and other non operative strategies have failed to prolong survival. With improved surgical techniques, resection of multiple tumours in more than one lobe and those with vascular involvement is now feasible and is only recently being explored.3,4 The aim of this study was to assess the result of major liver resection in patients with advanced (Stage IV) HCC in terms of safety and survival.
KeywordsHepatocellular Carcinoma Liver Resection Hepatic Resection Tumor Thrombus Percutaneous Ethanol Injection
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- 5.Hermanek P and S. LH. Liver; TNM classification of malignant tumours. 1992. Springer Verlag. Berlin.Google Scholar
- 13.Lotze MT, Flickinger JC and Carr BI. Hepatobiliary neoplasms, in Cancer principles and practice of oncology (De Vita VT, Hellman S and Rosenberg SA) 4th ed. 1993. J. B. Lippincott, Philadelphia, pp. 883–914Google Scholar
- 20.Wu CC, Ho WL, Yeh DC, Liu TJ and P’eng FK. Hepatic resection for bilobar multicentric hepatocellular carcinoma - is it justified(abstract)? Hepato-Gastroenterology 1998; 45(Supl. II): LXXXV.Google Scholar
- 21.Kim Hi, Song IS, Lim MK, Shon DH and Kwun KB. Indication and limitation of hepatectomy in advanced hepatocellular carcinoma(abstract). Hepato-Gastroenterology 1998; 45(Supl. II): LXXXII.Google Scholar
- 22.Regimbeau JM, Farges O, Shen BY, et al. Is surgery justified for large hepatocellular carcinoma(abstract)? Hepato-Gastroenterology 1998; 45(Supl. II): LXXI.Google Scholar
- 28.Konishi M, Ryu M, Kinoshita T and Inoue K. Surgical treatment for hepatocellular carcinoma with direct removal of tumor thrombus in the main portal vein(abstract). Hepato-Gastroenterology 1998; 45(Supl. II): LXXXI.Google Scholar
- 30.Yamamoto K, Takenaka K, Kawahara N, et al. Indications for palliative reduction surgery in advanced hepatocellular carcinoma. The use of a remnant tumour index. Arch Surg 1997; 132(120–3):Google Scholar
- 35.Ringe B, Wittekind C, Weimann A, Tusch G and Pichlmayr R. Results of hepatic resection and transplantation for fibrolamellar carcinoma. Surg Gynae Obst 1992; 175(4): 299–305.Google Scholar