Determination of Surgical Procedures by Preoperative Diagnosis -Hepatocellular Carcinoma-

Susumu Yamasaki, Tadatoshi Takayama, Tomoo Kosuge, Kazuaki Shimada, Junji Yamamoto, Hiroshi Hasegawa*

Department of Surgical Oncology, National Cancer Center Hospital and Ibaragi Central Hospital*

A determination of the surgical procedure for hepatocellular carcinoma (HCC) takes into consideration the functional and anatomical condition of the patient. Function of the liver should take precedence over the anatomical stage of the cancer. The functional condition usually is suggested by biochemical examination; however, that does not always correspond to the pathological status of the liver parenchyma. Final decision should be made after the macroscopic and/or histological observation at laparotomy. Preoperative imagings, although there has been remarkable progress in recent years, cannot given sufficient information about the anatomical status of the cancer. Intraoperative examinations by ultrasound and/or biopsy at laparotomy give us important information for the final decision. We use a "Risk Score" which is composed of 5 items in biochemical examination, but that is only part of the information needed for decision of the surgical procedure. Considering the frequency of intrahepatic metastasis of HCC through the portal vein. Theoritically wider resection is expected to give a better outcome. However the results which have been achieved do not support that expectation.

Key words
hepatocellular carcinoma, risk score, hepatectomy

Reprint requests
Susumu Yamasaki Department of Surgical Oncology, National Cancer Center Hospital
5-l-1 Tsukiji, Cyuou-ku, 104 JAPAN

Accepted
November 20, 1991

To read the PDF file you will need Abobe Reader installed on your computer.