Palliative surgical treatment for recurrent and non-resectable hepatocellular carcinoma.
Of 275 patients who had a radical hepatic resection for HCC, 143 (52%) experienced recurrences. Of these 143 patients, the liver was the site of first recurrence in 130 patients (91%). The first form of therapy for recurrent patients was transarterial chemoembolization (TACE) in 82 (74%), hepatic resection in 15 (14%) and percutaneous ethanol injection in 6 (5%) of the 111 patients who received regional therapy. Post-recurrent survival rates of TACE and hepatic resection were 37%, 77% at 3 years and 17%, 77% at 5 years, respectively. Wrapping therapy was performed in seven patients, two of whom had received repeat TACE for intrahepatic recurrence; the remaining 5 were unresectable cases. After wrapping therapy, the area of previous collateral feeders was be supplied by the hepatic artery. The high level of AFP decreased dramatically. This procedure resulted in a complete response in 2 patients, a partial response in 3 and no change in 2. Overall survival was 4-54 months, and the median survival was 18 months. Two patients are still alive, 18 and 20 months after the procedure.
Imaoka
S
S
Department of Surgery, Center for Adult Diseases, Osaka, Japan.
Sasaki
Y
Y
Masutani
S
S
Furukawa
H
H
Ishikawa
O
O
Kabuto
T
T
Kameyama
M
M
Koyama
H
H
Iwanaga
T
T
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006498:Hepatectomy; D006801:Humans; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000098:blood supply / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D010166:Palliative Care; D015996:Survival Rate
D000431:Ethanol