[Current approaches to surgical treatment of liver tumors].
Since 1990, 230 operations for focal pathologies in the liver have been carried out at the Center's clinics using such advanced procedures and equipment as radio-isotope examination of hepatic function, ultrasonography of the liver during surgery, ultrasound aspirator, water-flow scalpel, argon coagulator and adhesive dressing materials. The study included 75 resections for primary hepatic tumor (lethality-14.6%), 114 resections-disseminated tumor (lethality-5.2%) and 41 resections for benign tumors and non-tumor pathologies (no lethality). Preoperative chemotherapy was found to significantly increase the risk of postoperative complications in cases of liver resection. Five-year survival in such patients with primary tumor was 33.3%. The seven most significant prognostic factors in primary hepatic carcinoma were: portal invasion by tumor cells, number of tumor nodes in the liver, alpha-fetoprotein concentration, tumor node size, concomitant cirrhosis, age and extent of surgery. In patients with hepatic resection for solitary metastasis of the large bowel, 5-year survival was 28.6%. A regimen of adjuvant chemotherapy for solitary metastasis of colorectal cancer into liver is suggested. The data on 37 surgical patients with hepatic metastasis of non-colorectal cancer are presented. It was demonstrated that the liver should be resected in cases of solitary metastasis of renal carcinoma, adrenal gland, ovary, tests, breast, gallbladder and carcinoid.
Patiutko
Iu I
IuI
N.N. Blokhin Center for Cancer Research, Russian Academy of Medical Sciences, Moscow.
Sagaĭdak
I V
IV
Kotel'nikov
A G
AG
Badalian
Kh V
KhV
Tumanian
A O
AO
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006488:Hemostasis, Surgical; D006498:Hepatectomy; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D017075:Laser Coagulation; D002955:Leucovorin / Q000627:therapeutic use; D017093:Liver Failure / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D011994:Recombinant Proteins; D012086:Reoperation; D013997:Time Factors; D014464:Ultrasonic Therapy
D000276:Adjuvants, Immunologic; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D007370:Interferon Type I; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D002955:Leucovorin; D005472:Fluorouracil