Related Experiment Video
Updated: Jun 7, 2026
Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Salvage surgery for uncontrollable hepatocellular carcinoma treated with repeated non-surgical therapies
Toshiya Ochiai1, Teruhisa Sonoyama, Hisashi Ikoma
1Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. tochiai@koto.kpu-m.ac.jp
Background/Aims:
Some hepatocellular carcinoma (HCC) cases undergo surgery because tumor progression cannot be controlled by various non-surgical therapies. This retrospective study sought to clarify the clinicopathologic features of such HCC cases.
Methodology:
Among cases with solitary small HCCs (< or = 3.0cm at the time of detection), the clinicopathologic features of 7 patients who had undergone hepatectomy after various non-surgical therapies (Salvage (S) group) were analyzed and compared with those of 30 patients who received hepatectomy as the initial treatment (Control (C) group).
Results:
In S group, the serum alpha-fetoprotein level was higher (p = 0.045) and macroscopic ductal invasion was more common (p = 0.028) at the time of the operation. Lobectomy was more commonly performed (p = 0.034) and curability B (No residual cancer, but Stage III or IV) was more frequent (p = 0.011). Other organ recurrence was more common (p = 0.0044). The survival time after the initial treatment (post-initial treatment survival) was worse (p = 0.028). Univariate analyses revealed that those with maximum tumor sizes of > 3.0 cm at the time of the operation were significantly worse compared with the other patients (p = 0.012).
Conclusions:
The timing for changing from a non-surgical treatment to a surgical treatment is important.
