A Study of Hepatocellular Carcinoma Associated with Extrahepatic Primary Cancers

Kanji Ohiwa, Naofumi Nagasue, Hitoshi Kohno, Takafumi Hayashi, Masaaki Uchida, Akira Yamanoi, Yoshinari Takemoto, Yoshinari Makino, Takashi Ono, Jyunko Hayashi, Teruhisa Nakamura

Second Department of Surgery, Shimane Medical University

In 182 patients with hepatocellular carcinoma (HCC), 17 patients (9.3%) had 20 extrahepatic primary cancers. These were synchronous in 7 patients and metachronous in 10 patients. In 9 patients with metachronous multiple primary cancers (MPC), HCC was diagnosed after the treatment of extrahepatic primary cancers. The most common cancer associated with HCC was gastric cancer (52.9%). The average age in HCC with MPC was 65.0 years, and that in HCC without MPC was 61.0 years (p=0.087). The average age in metachronous MPC (68.1 yr) was significantly higher than that in synchronous MPC (60.6 yr, p<0.05). The frequency of a past history of blood transfusion in patients with metachronous MPC was 70.0%, and that in those with synchronous MPC was 28.6% p=0.092). Of 17 patients with MPC, 11 (64.7%) underwent radical resection for both cancers. The 5-year survival rate was 34.1% after radical resection for both cancers, no different from that of radical resection for primary HCC alone. It was thought that aggressive therapy should be performed even though the patient had MPC, if indicated for radical resection.

Key words
hepatocellular carcinoma, extrahepatic primary cancer, multiple primary cancer

Reprint requests
Kanji Ohiwa Second Department of Surgery, Shimane Medical University
89-1 Enya-cho, Izumo, 693 JAPAN

Accepted
July 7, 1993

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