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CYTOREDUCTIVE SURGERY IN MULTIDISCIPLINARY TREATMENT OF ADVANCED HEPATOCELLULAR CARCINOMA
Author(s) -
Lai Eric C. H.,
Tang ChungNgai,
Ha Joe P. Y.,
Tsui David K. K.,
Li Michael K. W.
Publication year - 2008
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2008.04544.x
Subject(s) - medicine , surgery , hepatocellular carcinoma , randomized controlled trial , hepatectomy , debulking , survival rate , resection , cancer , ovarian cancer
Background: Cytoreductive surgery (debulking surgery) as a multidisciplinary treatment approach for inoperable advanced hepatocellular carcinoma has been shown to prolong survival and provide symptomatic relief for good surgical risks patients in non‐randomized studies before. Methods: A non‐randomized comparative study was performed in a tertiary referral centre between January 2001 and December 2006. The outcome of a consecutive series of patients with inoperable advanced hepatocellular carcinoma who received cytoreductive surgery was compared with a control group of patients who received palliative treatment without surgery. Two techniques of cytoreductive surgery were used: (i) partial hepatectomy for the main tumour plus intraoperative local ablative therapy for the smaller tumour nodules in the liver remnant; and (ii) partial hepatectomy for the main tumour plus postoperative transarterial chemoembolization. Results: The overall survival of cytoreductive surgery group ( n = 18) was significantly better than that of the palliative treatment group ( n = 15) (3‐year overall survival, 54% vs 22%; median survival, 18 vs 11 months) (P = 0.038). In the cytoreductive surgery group, there was no operative mortality. Postoperative morbidity rate was 16.7%. The mean hospital stay was 8 days. Conclusion: Cytoreductive treatment strategy for advanced hepatocellular carcinoma can be considered as one of the options in selected patients with low operative risks and reasonable liver function. Further prospective randomized trials are required to validate this aggressive surgical approach.