[Treatment of liver cancer and concomitant esophageal varices]

We have treated 123 cirrhotic patients having liver cancer associated with esophageal varices. Among these patients, 10 underwent hepatic resection together with variceal surgeries simultaneously. These procedures were feasible when the liver tumor was detected in an early stage, and hepatocellular function was preserved as much as major hepatic resection was acceptable. One, 2 and 5 year survival rates were 73.4%, 58.7% and 29.4%, respectively. In 5 patients with non-resectable hepatoma, variceal surgery was done, but 4 died of hematemesis finally. The result is suggestive that variceal surgery in such patients appears to be ineffective. Recently, endoscopic sclerotherapy had been performed for variceal bleeding in poor risk patients. Lipiodol, contrast material, has been attempted to use for chemotherapy for advanced hepatocellular carcinoma, making use of the characteristic of the oli that this material remains selectively in the tumor for a long time when it is administered through the artery feeding the tumor. We have used this mode of therapy and prominent decrease of alpha-fetoprotein has been evident in 5 patients with non-resectable hepatoma until the present time. These less invasive methods are considered to be treatment of choice in patients with advanced liver cancer and concomitant esophageal varices.