title: [Multimodal treatment of hepatocellular carcinoma].
abstract: BACKGROUND
  Several options now available create the need for a multidisciplinary approach to the treatment of patients with hepatocellular carcinoma (HCC).
  
  
  OBJECTIVE
  To describe the experience with a group of patients with HCC diagnosed and treated with the current modalities for control of this entity.
  
  
  METHODS
  A total of 169 consecutive patients with HCC treated between January 1990 and February 1998; 41 liver resections, 14 liver transplants, 87 chemoembolizations and 8 alcoholizations were performed. The median follow-up time was 23.6 months (range: 0.2-94). In the other 29 patients, only support treatment was administered.
  
  
  RESULTS
  Resected patients had a lower median hospitalization rate, blood transfusions, and hospitalization mortality. Recurrence was 42.1% in the resected group but 0% in transplanted patients. The overall survival at 36 months was better for transplanted than for resected patients (100% vs. 62.3%; p < 0.02). The median survival time was 13 months (IC: 95%: 11-15 months) in chemoembolizated patients.
  
  
  CONCLUSIONS
  1. The outcome of patients with HCC is influenced by several factors, therefore calling for multimodal approach. 2. Surgical procedures should be indicated with low morbimortality rates. 3. The overall survival and disease free survival time is better in transplanted patients than in the resected group. 4. The survival time of patients with unresectable HCC without extra-liver disease could be improved with chemoembolization.
authors.affiliation: Hospital Italiano de Buenos Aires (HIBA). eduardod@infostar.com.ar
authors.forename: E
authors.initials: E
authors.lastname: De Santibañes
authors.forename: L
authors.initials: L
authors.lastname: Mc Cormack
authors.forename: J
authors.initials: J
authors.lastname: Pekolj
authors.forename: J
authors.initials: J
authors.lastname: Mattera
authors.forename: J
authors.initials: J
authors.lastname: Acuña Barrios
authors.forename: A
authors.initials: A
authors.lastname: Aldet
authors.forename: R
authors.initials: R
authors.lastname: García Monaco
authors.forename: A
authors.initials: A
authors.lastname: Gadano
authors.forename: D
authors.initials: D
authors.lastname: D'Agostino
authors.forename: C
authors.initials: C
authors.lastname: Bonofiglio
authors.forename: M
authors.initials: M
authors.lastname: Ciardullo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome