Clinicopathological study of hepatocellular carcinoma with diaphragmatic involvement

Leung, Kam-Tong; Chui, A.K.K; Lai, Paul B.S.; Liew, C. T.; Lau, W. Y.

doi:10.1046/j.1365-2168.2001.01750.x

Cited by 11 publications

(14 citation statements)

References 5 publications

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“…40 For HCCs located below the diaphragmatic dome, combined resection of the liver with diaphragm is safe and gives survival comparable to those without diaphragmatic involvement, probably because histological invasion is unusual. 28,29 Gross portal vein tumor thrombosis is associated with poor prognosis. 41 Technically, however, removal of extensive tumor thrombi such as those extending into or beyond the portal bifurcation can be performed with acceptable mortality, which can lead to long-term survival in selected patients.…”

Section: Oncological Outcome: Prognostic Factorsmentioning

confidence: 99%

“…27 For diaphragmatic invasion, combined resection of the diaphragm is a safe technique that can give long-term survival comparable to those cases without such invasion. 28,29 Postoperatively, intravenous fluid of 5% glucose with electrolyte composition of quarter-normal saline is given sparingly to maintain a low central venous pressure. Hypovolemia is corrected by intravenous colloids rather than crystalloids to avoid tissue and liver edema.…”

Section: Perioperative Managementmentioning

confidence: 99%

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Current status of hepatic resection for hepatocellular carcinoma

Yanaga

2004

J Gastroenterol

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Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide. For this disease, a variety of therapeutic measures have been applied, including hepatic resections, total hepatectomy followed by allografting, transarterial chemoembolization, and percutaneous tumor ablative therapy by ethanol, microwave coagulation, and radiofrequency ablation. This article focuses on the current status of hepatic resections for HCC.

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Section: Oncological Outcome: Prognostic Factorsmentioning

confidence: 99%

Section: Perioperative Managementmentioning

confidence: 99%

Current status of hepatic resection for hepatocellular carcinoma

Yanaga

2004

J Gastroenterol

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“…[3][4][5] On the other hand, a blunt dissection is usually possible and is commonly used in HCC with adhesion to the diaphragm. 6 However, none of these four previously published reports about diaphragmatic involvement of HCC directly compared the surgical results, such as surgical risks and long-term survival between the patients receiving an en bloc resection of the diaphragm and patients treated by a blunt dissection.…”

Section: Introductionmentioning

confidence: 99%

Surgical impacts of an en bloc resection of the diaphragm for hepatocellular carcinoma with gross diaphragmatic involvement

et al. 2011

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“…14 Rarely, intraabdominal adhesions and scarring induced by the previous operation may cause HCC adhesion to and invasion of the gastrointestinal tract serosa. 15 To date, 6 retrospective studies 4,5,[8][9][10][11] in the English literature report that a total of 147 pa tients with HCC extending to adjacent organs have undergone en bloc resection ( Table 3). The mean age of these patients ranged from 46.2 (standard deviation [SD] 15.3) to 61.3 (SD 11.8) years.…”

Section: Researchmentioning

confidence: 99%

“…Although combined resection of the organs is frequently performed during hepatectomy for HCC, [5][6][7] only a few authors have reported their surgical experience. 4,5,[8][9][10][11] In the present study, we analyzed the safety and effectiveness of en bloc resection for HCC extending to adjacent organs.…”

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confidence: 99%

Results of en bloc resection for hepatocellular carcinoma extending to adjacent organs

Zhou

Sui²,

Li³

et al. 2012

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Results of en bloc resection for hepatocellular carcinoma extending to adjacent organsBackground: To curatively resect hepatocellular carcinoma (HCC) with adjacent organ extension, the combined resection of these organs is inevitable. We analyzed the safety and effectiveness of en bloc resection for HCC extending to adjacent organs. Methods:From December 2002 to May 2006, we compared the surgical outcomes of patients with HCC extending to adjacent organs with those of closely matched, randomly selected patients with HCC without adjacent organ extension. Results:We included 42 patients whose HCC extended to adjacent organs and 126 pa tients whose HCC did not extend to adjacent organs. There was no significant difference in survival, operative morbidity or mortality between the groups. In patients with HCC extending to adjacent organs, histopathological examination of the specimen revealed true tumour invasion in 13 and adhesion in 29 patients. Those with tumour invasion were more likely to have a high incidence of capsule infiltration, microvascular invasion and early intrahepatic recurrence (≤ 1 yr after hepatectomy).The 5-year overall survival of patients with tumour invasion was 11.5%, whereas that of patients with tumour adhesion was 38.1% (p = 0.033). Conclusion:En bloc resection is a safe and effective therapy for HCC extending to adjacent organs. Tumour invasion to adjacent organs exhibits a more aggressive clinical behaviour and is associated with worse survival than tumour adhesion.Contexte : La résection curative d'un carcinome hépatocellulaire ayant envahi des organes adjacents entraîne inévitablement la résection de ces organes. Nous avons analysé l'innocuité et l'efficacité d'une résection radicale dans les cas de carcinome hépatocellulaire s'étant propagé aux organes adjacents. Méthodes :Pour la période allant de décembre 2002 à mai 2006, nous avons comparé les résultats de la chirurgie chez des patients atteints d'un carcinome hépatocellu-laire ayant envahi des organes adjacents aux résultats obtenus chez des patients sélec-tionnés au hasard mais étroitement jumelés, atteints d'un carcinome hépatocellulaire sans propagation aux organes adjacents.Résultats : Nous avons inclus 42 patients dont le carcinome hépatocellulaire s'était propagé aux organes adjacents et 126 patients dont le carcinome hépatocellulaire n'avait pas envahi les organes adjacents. On n'a noté aucune différence significative quant à la survie, la morbidité opératoire ou la mortalité entre les groupes. Chez les patients atteints d'un carcinome hépatocellulaire propagé aux organes adjacents, l'examen histopathologique du spécimen a révélé un réel envahissement tumoral chez 13 patients et des adhésions chez 29 patients. Les patients atteints d'un envahissement tumoral étaient plus susceptibles de présenter une forte incidence d'infiltration capsulaire, d'envahissement microvasculaire et de récurrence intrahépatique précoce (≤ 1 an après l'hépatectomie). La survie globale à 5 ans des patients présentant un envahissement tumoral était ...

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Clinicopathological study of hepatocellular carcinoma with diaphragmatic involvement

Cited by 11 publications

References 5 publications

Current status of hepatic resection for hepatocellular carcinoma

Current status of hepatic resection for hepatocellular carcinoma

Surgical impacts of an en bloc resection of the diaphragm for hepatocellular carcinoma with gross diaphragmatic involvement

Results of en bloc resection for hepatocellular carcinoma extending to adjacent organs

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