Multimodal therapy of hepatocarcinoma: Personal experience on 90 cases

Background/Aims: In recent years, surgical and non-surgical options have be en developed in the treatment of hepatocellular carcinoma in cirrhotic pati ents. We review our personal series from 1995-1999, in order to assess the choice of treatment. Methodology: Of 90 cases of hepatocellular carcinoma observed in the years 1995-1999, 15 underwent curative resective surgery; in 42 cases TAE, PEI or RITA were utilized (9 of them as multimodal therapy). In the remaining 33 patients any kind of therapy was scheduled. Results: the mean survival of the 15 resected patients was 18 months, non-s tatistically better than RITA survival, compared by Log-Rank test. Perioper ative mortality calculated in all procedures was 5.2% (2 pts surgery, 1 pt TAE). Conclusions: The high percentage of not treated hepatocellular carcinomas i n our series is generally due to large tumor size diagnosed in advanced Chi ld's stage. PEI, TAE and RITA have to be considered effective and safe for palliation for HCCs. However, surgical resection represents the curative th erapy in selected cirrhotic patients affected by HCC.