Surgical approach for extrahepatic metastasis of HCC in the abdominal cavity.
OBJECTIVE
Despite recent development of therapeutic strategies for intrahepatic lesions, standard guidelines for treatment of extrahepatic metastases of hepatocellular carcinoma have not been established.


METHODS
Surgical resection for intra-abdominal extrahepatic metastases of hepatocellular carcinoma was performed on 10 patients at our institution between 1992 and 2008. We retrospectively examined the clinicopathologic features and significance of a surgical approach in these patients.


RESULTS
Nine of the 10 patients received treatment for primary hepatocellular carcinoma before surgery for intra-abdominal extrahepatic metastasis. A simultaneous intrahepatic lesion was detected in half of the patients when the extrahepatic metastasis was resected. Extrahepatic recurrent organs included adrenal glands, lymph nodes, abdominal wall, stomach and diaphragm. The mean survival period after resection was 36.1 months. Two patients are still alive without further recurrence. One patient died of retroperitoneal recurrence and 7 died of intrahepatic recurrence or liver failure after resection.


CONCLUSIONS
With careful case selection, considering that not all extrahepatic metastases suggest systemic spread of hepatocellular carcinoma, surgical treatment for metastatic lesions in the abdominal cavity can provide a relatively good prognosis.
Department of Surgery, Takamatsu Hospital, Kagawa, Japan. sanocchi14@hotmail.com
Takanori
T
Sano
Kunihiko
K
Izuishi
Ryusuke
R
Takebayashi
Shintaro
S
Akamoto
Keitaro
K
Kakinoki
Keiichi
K
Okano
Tsutomu
T
Masaki
Yasuyuki
Y
Suzuki
D034841:Abdominal Cavity / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate