title: Resection of extrahepatic hepatocellular carcinoma metastasis can result in long-term survival.
abstract: Hepatocellular carcinoma (HCC) is one of the most common primary cancers in the world and the third most common cause of cancer mortality world-wide. Surgery is the gold standard in the treatment of patients with HCC. The prognosis is mainly determined by the underlying liver disease and recurrent rates. In the Western World, up to 30% of the patients with HCC have a non-cirrhotic liver. The main prognostic factor in this special group of patients are the recurrences. Most recurrences are intrahepatic; however, 30% of the recurrences are extrahepatic. The role of resection in case of intrahepatic recurrences is widely accepted, particularly in the non-cirrhotic liver. The role of resection in extrahepatic HCC recurrences is not well established and unknown among many physicians. We present two patients with HCC in a non-cirrhotic liver with extrahepatic recurrences and long-term survival after resection. The corresponding literature support an aggressive approach in case of extrahepatic HCC recurrence in selected cases: resectable metastasis, preserved liver function, absence of intracranial metastasis and control of the primary tumour. Further research is warranted because of the limited number of reports and the absence of randomized trials.
authors.affiliation: Department of Surgical Oncology, Erasmus Medical Centre, Rotterdam, The Netherlands. c.verhoef@erasmusmc.nl
authors.forename: C
authors.initials: C
authors.lastname: Verhoef
authors.forename: F A
authors.initials: FA
authors.lastname: Holman
authors.forename: S M
authors.initials: SM
authors.lastname: Hussain
authors.forename: R A
authors.initials: RA
authors.lastname: de Man
authors.forename: J H W
authors.initials: JH
authors.lastname: de Wilt
authors.forename: J N M
authors.initials: JN
authors.lastname: IJzermans
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000556:secondary* / Q000601:surgery*; D008099:Liver / Q000502:physiology; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D011379:Prognosis; D012008:Recurrence; D013534:Survival; D035441:Thoracic Wall / Q000473:pathology