Surgical intervention for patients with stage IV-A hepatocellular carcinoma without lymph node metastasis: proposal as a standard therapy

Annals of Surgery
Iwao IkaiM Yamamoto

Abstract

The aim of this study was to evaluate the effects of surgical treatments for patients with stage IV-A hepatocellular carcinoma (HCC) without lymph node metastasis. Nonsurgical therapy for highly advanced HCC patients has yielded poor long-term survival. Surgical intervention has been initiated in an effort to improve survival. The outcome of 150 patients who underwent hepatic resection was studied. Survival analysis was made by stratifying stage IV-A HCC patients into two groups-those with and those without involvement of a major branch of the portal or hepatic veins. Those with involvement were further divided into subgroups according to major vascular invasions. Patients who had multiple tumors in more than one lobe without vascular invasion had a significantly better 5-year survival rate (20%) than those with vascular invasion (8%) (p < 0.01). The survival rate of patients with hepatic vein tumor thrombi (10%) was better than the rate for those with tumor thrombi in the inferior vena cava (0%), in whom no patients survived more than 2 years, although the survival rate for those with portal vein tumor thrombi in the first branch (11%) was no different from the rate for that in the portal trunk (4%). The operative mortality de...Continue Reading

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Citations

May 6, 2005·Langenbeck's Archives of Surgery·Xiao-Ping Chen, Zhi-Yong Huang
Jan 12, 2008·Langenbeck's Archives of Surgery·Kazuaki ShimadaTomoo Kosuge
May 29, 2000·Journal of Gastroenterology and Hepatology·S Okada
Mar 12, 2009·Annals of Surgical Oncology·Luca AldrighettiGianfranco Ferla
Dec 17, 2009·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Shinji SugaharaKoichi Tokuuye
Feb 28, 2006·Journal of the American College of Surgeons·Iwao IkaiYasuyuki Shimahara
May 9, 2003·Surgical Oncology Clinics of North America·Iwao IkaiYoshio Yamaoka
Jan 17, 2015·Frontiers in Surgery·Zenichi MoriseMasashi Isetani
Mar 16, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jean-Nicolas VautheyDavid M Nagorney
Aug 30, 2008·International Journal of Radiation Oncology, Biology, Physics·Shintaro ShiraiMotoki Nakai
Feb 6, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Masatoshi Makuuchi, Keiji Sano
Sep 24, 2011·European Journal of Gastroenterology & Hepatology·Yen-Huai LinCheng-Yen Chang
Apr 21, 2020·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·David FuentesErik Cressman

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