The Significance of Hepatectomy for Stage IV Hepatocellular Carcinoma

Shinichi Iwamoto, Yo Sasaki, Shingi Imaoka, Seizou Masutani, Ichiro Ohashi, Osamu Ishikawa, Hiroshi Furukawa, Masao Kameyama, Toshiyuki Kabuto, Hiroki Koyama, Takeshi Iwanaga

Department of Surgery, The Center for Adult Diseases, Osaka

We tried to determine the significance of surgery for 38 patients with Stage IV hepatocellular carcinoma (HCC) who underwent hepatic resection by the end of December 1990. Of the 38 patients, 17 had relative noncurative (RN) resections and the remaining 21 had absolute noncurative (AN) resections. The 5-year survival rate for all Stage IV patients was 19%, and the rate was significantly poorer than the rates for patients with Stage I, II and III. However the 5-year survival rate for the patients with RN resection with Stage IV was almost as good as the rates for patients with Stage II and Stage III who had relative curative and RN resections. On the other hand, no Stage IV patients with AN resection survived longer than 2 years after surgery. Tumor-related factors in the RN resection group were significantly better than those in the AN resection group. Of the RN resection cases, the outcome of the patients who seemed to have multicentric tumors was significantly better than that of the other patients. In consequence, for Stage IV HCC patients, RN resection can be recommended if it is possible. However the significance of AN resection is still unknown.

Key words
StageIVhepatocellularcarcinoma, multicentrictumorofhepatocellularcarcinoma, absolute noncurative hepatectomy, relative noncurative hepatectomy, TAE for Stage IV hepatocellular carcinoma

Reprint requests
Shinichi Iwamoto Department of Surgery, The Center for Adult Diseases, Osaka
1-3-3 Nakamichi, Higashinari-ku, Osaka, 537 JAPAN

Accepted
April 1, 1992

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