HEPATOCELLULAR-CARCINOMA OF THE INTRABILIARY GROWTH TYPE

Background. To determine the optimal surgical therapy for patients wit h the intrabiliary growth type of hepatocellular carcinoma (HCC), Meth ods. We evaluated 257 patients with HCC who underwent liver resection from 1981 to 1990 in Kyushu University Hospital. Results. There were 1 3 (5.1 per cent) with the intrabiliary growth type of HCC, Total bilir ubin and r-glutamyl transpeptidase levels were higher (p < 0.05), and diameter of these tumors was larger in patients with intrabiliary grow th type of HCC (p < 0.05), There were significant correlations between patients with the intrabiliary growth type of HCC and intrahepatic me tastasis (p < 0.01), and port;il vein infiltration (p < 0.01). Surviva l time of patients with the intrabiliary growth type was significantly shorter than that in the control group (p < 0.05), Nevertheless, two of three patients with the intrabiliary growth type of HCC who underwe nt resection of more than a 10 mm surgical margin survived for 5 years , respectively. Conclusions. A large number of patients with the intra biliary growth type of HCC were advanced HCCs with intrahepatic metast asis or portal vein infiltration, However, we favour the view that pat ients have had a better prognosis if hepatectomy of more than a 10 mm surgical margin had been done.