Hepatoma

Wanebo, Harold J.; Vezeridis, Michael P.

doi:10.1002/jso.2930530512

Cited by 4 publications

(1 citation statement)

References 60 publications

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“…Despite improvements in the screening of high risk patients by measurement of alpha fetoprotein serum levels and diagnostic imaging to detect subclinical hepatocellular carcinoma,3 most patients still present with advanced tumors 4. A recent review of the literature by Wanebo and Vezeridis5 reveals a resectability rate in the 20%–25% range in Western and 7%–46% in Eastern series. This is due to either anatomical or functional restrictions, the latter caused by underlying liver cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Liver transplantation for hepatocelluar carcinoma, with additional reference to bench surgery

Pichlmayr

Weimann

Lamesch

et al. 1994

J Hep Bil Pancr Surg

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In 98 liver transplantations for hepatoceltular carcinoma during a 20-year period, a strong correlation was found between survival and UICC tumor stage. From these results, tumor stage IV and the presence of lymph node metastases should be considered exclusion criteria for liver transplantation. It remains an open issue whether in potentially resectable stage I or II hepatocellular carcinoma with underlying cirrhosis liver transplantation should be preferred. Generally, resection will remain the treatment of choice. For anatomic restrictions without functional impairment, extension of resectability can be obtained by total vascular occlusion and hypothermic perfusion of the liver via different techniques, such as in situ, ante situm, or ex situ ("bench") procedure. The feasibility of these techniques was demonstrated in five patients with hepatocellular carcinoma; there was no postoperative mortality in the group and the survival time was 12-27 months. According to this experience, appropriate indications for this procedure are patients where liver transplantation is contraindicated, the improvement of resectability in borderline cases to avoid liver transplantation, and the possible extension of resectability in conventionally resectable tumors. With regard to promising results in the literature, further investigations will be required to evaluate tumor stage and multimodality therapy concepts including in situ, ante situm, and the bench procedure, as well as liver transplantation, as complementary treatment options to conventional resection.

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Section: Introductionmentioning

confidence: 99%

Liver transplantation for hepatocelluar carcinoma, with additional reference to bench surgery

Pichlmayr

Weimann

Lamesch

et al. 1994

J Hep Bil Pancr Surg

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Hepatocellular carcinoma in children

et al. 1997

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Hepatocellular carcinoma (HCC) occurs more frequently in subsaharan Africa and the Orient than in other geographical regions, but remains an uncommon tumour of childhood. We review six children with HCC (mean age 13 years) treated by the paediatric oncology unit at Tygerberg Hospital in Cape Town over an 8-year period (1983 - 1990). Patients presented with epigastric and right upper quadrant discomfort and hepatomegaly. The hepatitis B serum antigen (HbsAg) was positive in three patients; serum alpha-fetoprotein (AFP) levels were markedly elevated in three (range 100 - 453,000 microg/l). Age and sex did not differ significantly and all patients initially had irresectable advanced-stage tumours. Morphologically, three were highly malignant adult-type pleomorphic HCCs, two were differentiated tumours, and one a fibrolamellar subtype. The mean 2-year survival was 33% and the 5-year survival 16.6%. The biological behaviour and response to treatment of the tumours varied. Whereas three patients had a poor response to therapy, two with poorly-differentiated tumours, negative HbsAg, and normal serum AFP levels responded to doxorubicin/cisplatinum chemotherapy. This facilitated radical surgical excision. One patient of this group has survived for more than 75 months following surgical resection and remains well. HCC remains an uncommon tumour of childhood with a high mortality. Aggressive chemotherapeutic regimes in combination with surgical resection may lead to improved survival in some cases. Prevention of hepatitis B remains a priority.

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