SURGICAL-MANAGEMENT OF HEPATOCELLULAR-CARCINOMA IN GENETIC HEMOCHROMATOSIS

From 1975 to 1989, 51 patients presenting with hepatocellular carcinom a complicating genetic haemochromatosis were managed in our institutio n. Twenty-one patients underwent a laparotomy. Laparotomy was limited to surgical exploration or palliation in 8 patients in whom the tumour was deemed unresectable. Thirteen patients underwent either a partial hepatectomy (11 patients) or a total hepatectomy and liver transplant ation (2 patients). Actuarial survival at 1 and 3 years following part ial hepatectomy was 56% and 40% respectively. There was one hospital d eath in the resection group and in the transplant group. Only 3 patien ts have remained free of tumour recurrence after a mean follow-up of 1 8 months. Common clinical and histological features for patients with this condition included masculine gender, age 50 years or above, 10 or more years of history of diagnosed genetic haemochromatosis, high alc ohol intake, and grade III or IV hepatic fibrosis.