Two-stages resection for advanced hepatocellular carcinoma

Abstract

We performed two-stage resection for sixteen patients with advanced hepatocellular carcinoma from January, 1987 to July, 1991. All patients underwent various surgical therapies prior to resection which included gauze packing hemostasis in 1 case, hyperthermia plus radiotherapy in 1, hepatic arterial ligation in 2, operative hepatic arterial embolization in 3, and transcatheter embolization in 9. The median interval between the first therapy and tumour resection was 59 days with a range of 29--769 days, and the median diameter of tumours decreased from 10.5 cm to 7.5 cm. The majority of precedures on two-stage resection were irregular hepatectomy or Iobectomy under occlusion of porta hepatis. Regular hepatectomies were done in 4 cases. Pathalogical examination showed complete coagulation necrosis in 3 specimens. However, in the others were still found residual viable tumours. Survival periods of the patients who received two-stage resection were from 4 months to 4 years except 2 operative death. The significance, possibility as well as methods of two-stage resection were discussed.