Wy. Tung et al., SURGICAL RESECTION OF PRIMARY HEPATOCELLULAR-CARCINOMA EXTENDING TO ADJACENT ORGAN(S), European journal of surgical oncology, 22(5), 1996, pp. 516-520
Primary hepatocellular carcinoma (HCC) extending to the adjacent organ
(s) is sometimes encountered in patients with large, peripherally loca
ted tumours, Over a l-year period, a total of 151 patients received cu
rative resection of HCC at the Surgical Department of Veterans General
Hospital-Taipei, Taiwan, Of these patients, 21 underwent hepatic rese
ction combined with en-bloc resection of the adjacent organ(s) because
tumour extension was found during operation, Subsequent histological
examination of the resected specimens found evidence of HCC invasion i
nto the resected adjacent organ(s) in only nine patients (group I), an
d the remaining 12 patients showed no evidence of extrahepatic HCC inv
asion (group II), Twenty-seven HCC patients with clinico-pathologicall
y matched tumours but without extrahepatic extension mere selected as
controls (group III), One patient in group I died of hepatic failure a
fter the operation, The morbidity rate was 48% in group I and group II
patients, and 30% in group III patients, The difference was not stati
stically significant, On evaluating the clinico-pathological factors,
including DNA ploidy status of the tumours, there mere no significant
differences between tumours with and without extrahepatic invasion, Pa
tients with locally invasive HCC (group I) had disease-free and overal
l survival rates comparable with those of the patients without local t
umour invasion (group II and III), We conclude that HCC with invasion
to the adjacent organ(s) does not seem to be directly related to the '
aggressiveness' of the tumour, and extrahepatic infiltration of the tu
mour does not preclude a chance of cure, Our results underscore the ne
ed for en-bloc resection as treatment of choice for these patients.