title: Clinical manifestations and survival of hepatocellular  carcinoma patients with peritoneal metastasis.
abstract: OBJECTIVE
  Peritoneal metastasis is an uncommon manifestation of hepatocellular carcinoma (HCC). The aim of the present paper was to investigate the characteristics and survival of HCC patients with peritoneal metastases.
  
  
  METHODS
  From January 1985 to December 2004, we retrospectively reviewed the records of 53 Taiwanese HCC patients with peritoneal metastases.
  
  
  RESULTS
  Peritoneal metastases were detected at the time of HCC diagnosis (synchronously) in 10 patients and after the initial therapy for the primary tumors (metachronously) in 43 patients. The mean time for development of the metachronous peritoneal metastases was similar whether the primary cancer was treated with surgery (24 months) or transarterial chemoembolization (22.2 months). The single patient whose primary cancer was treated with supportive care alone developed peritoneal metastasis only 7.5 months after detection of the primary cancer. Surgical resection of the peritoneal metastases was possible in two-thirds of the 43 metachronous patients. The median survival for those who received surgery for these metastases was 12.5 months vs. 2.1 months for those without surgery (P = 0.0013). However, there was no difference in survival if patients were stratified to Child-Pugh grade.
  
  
  CONCLUSIONS
  Peritoneal metastases of HCC are rare and can occur synchronously or metachronously. Though increased long-term survival was found in patients who had surgical removal of peritoneal metastases, the main determinant of better survival is Child-Pugh grade.
authors: Department of Internal Medicine, Far Eastern Memorial Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Chien-Chu
authors: CC
authors: Lin
authors: Hsiao-Ping
authors: HP
authors: Liang
authors: Hsuan-Shu
authors: HS
authors: Lee
authors: Guan-Tarn
authors: GT
authors: Huang
authors: Pei-Ming
authors: PM
authors: Yang
authors: Ming-Chih
authors: MC
authors: Ho
authors: Po-Huang
authors: PH
authors: Lee
authors: Yuk-Ming
authors: YM
authors: Tsang
authors: Ding-Shinn
authors: DS
authors: Chen
authors: Jin-Chuan
authors: JC
authors: Sheu
authors: Chien-Hung
authors: CH
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome