Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1993 Feb;217(2):149–154. doi: 10.1097/00000658-199302000-00009

Improved survival for hepatocellular cancer with combination surgery and multimodality treatment.

J V Sitzmann 1, R Abrams 1
PMCID: PMC1242754  PMID: 8382468

Abstract

Forty-one hepatic resections for malignant hepatomas were done in 35 consecutive patients from August 1985 to 1990. Twenty-one patients presented initially with resectable lesions and underwent resection for curative intent. Fourteen patients initially presented with unresectable intrahepatic disease. These patients underwent combined radiation and chemotherapy. Radiation consisted of external beam in all patients and 131I-antiferritin in 10 patients. Greater than 50% tumor reduction was noted in all patients, and resection then was performed. Six patients recurred and were re-resected. Complications occurred in 15 patients (36%), with no difference between groups. There were no perioperative deaths. Five-year actuarial survival was 45% and 48% for resection and multimodality. The authors conclude that some patients with unresectable intrahepatic hepatoma may successfully be converted to resectable by multimodality radiation/chemotherapy. The survival of these patients is similar to that of primary resected patients. Further, multiple, sequential resections appear to significantly prolong survival and can be performed with an acceptable morbidity and mortality rates.

Full text

PDF
153

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bezwoda W. R., Weaving A., Kew M., Derman D. P. Combination chemotherapy of hepatocellular cancer. Comparison of adriamycin + VM 26 + 5-fluorouracil with mAMSA + VM 26 + 5-fluorouracil. Oncology. 1987;44(4):207–209. doi: 10.1159/000226478. [DOI] [PubMed] [Google Scholar]
  2. Di Bisceglie A. M., Rustgi V. K., Hoofnagle J. H., Dusheiko G. M., Lotze M. T. NIH conference. Hepatocellular carcinoma. Ann Intern Med. 1988 Mar;108(3):390–401. doi: 10.7326/0003-4819-108-3-390. [DOI] [PubMed] [Google Scholar]
  3. Friedman M. A. Primary hepatocellular cancer--present results and future prospects. Int J Radiat Oncol Biol Phys. 1983 Dec;9(12):1841–1850. doi: 10.1016/0360-3016(83)90352-8. [DOI] [PubMed] [Google Scholar]
  4. Klein J. L., Nguyen T. H., Laroque P., Kopher K. A., Williams J. R., Wessels B. W., Dillehay L. E., Frincke J., Order S. E., Leichner P. K. Yttrium-90 and iodine-131 radioimmunoglobulin therapy of an experimental human hepatoma. Cancer Res. 1989 Nov 15;49(22):6383–6389. [PubMed] [Google Scholar]
  5. Nagao T., Inoue S., Goto S., Mizuta T., Omori Y., Kawano N., Morioka Y. Hepatic resection for hepatocellular carcinoma. Clinical features and long-term prognosis. Ann Surg. 1987 Jan;205(1):33–40. doi: 10.1097/00000658-198701000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Okuda K., Ohtsuki T., Obata H., Tomimatsu M., Okazaki N., Hasegawa H., Nakajima Y., Ohnishi K. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer. 1985 Aug 15;56(4):918–928. doi: 10.1002/1097-0142(19850815)56:4<918::aid-cncr2820560437>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  7. Rostock R. A., Fishman E. K., Order S. E. CT scanning for radiation therapy treatment planning of hepatoma. Int J Radiat Oncol Biol Phys. 1985 Jul;11(7):1413–1418. doi: 10.1016/0360-3016(85)90259-7. [DOI] [PubMed] [Google Scholar]
  8. Sitzmann J. V., Coleman J., Pitt H. A., Zerhouni E., Fishman E., Kaufman S. L., Order S., Grochow L. B., Cameron J. L. Preoperative assessment of malignant hepatic tumors. Am J Surg. 1990 Jan;159(1):137–143. doi: 10.1016/s0002-9610(05)80619-1. [DOI] [PubMed] [Google Scholar]
  9. Sitzmann J. V., Order S. E., Klein J. L., Leichner P. K., Fishman E. K., Smith G. W. Conversion by new treatment modalities of nonresectable to resectable hepatocellular cancer. J Clin Oncol. 1987 Oct;5(10):1566–1573. doi: 10.1200/JCO.1987.5.10.1566. [DOI] [PubMed] [Google Scholar]
  10. Stillwagon G. B., Order S. E., Guse C., Klein J. L., Leichner P. K., Leibel S. A., Fishman E. K. 194 hepatocellular cancers treated by radiation and chemotherapy combinations: toxicity and response: a Radiation Therapy Oncology Group Study. Int J Radiat Oncol Biol Phys. 1989 Dec;17(6):1223–1229. doi: 10.1016/0360-3016(89)90530-0. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES