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En bloc resection for extensive hepatocellular carcinoma: is it advisable?
1Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
World Journal of Surgery
|November 1, 1994
Summary
Aggressive en bloc resection for hepatocellular carcinoma (HCC) invading adjacent organs is recommended. This approach showed similar outcomes to standard resections in a controlled study, suggesting its value in select cases.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) invasion into adjacent organs presents complex surgical challenges.
- Determining the optimal surgical strategy for locally advanced HCC is critical.
Purpose of the Study:
- To evaluate the efficacy and safety of en bloc resection for HCC with adjacent organ invasion.
- To compare outcomes of aggressive resection versus standard resection in HCC patients.
Main Methods:
- A retrospective controlled study comparing nine patients undergoing en bloc resection (Group I) with eighteen controls (Group II).
- Inclusion criteria for en bloc resection included solitary tumors without vascular invasion or metastasis.
- Preoperative imaging included ultrasonography, CT, and arteriography; intraoperative ultrasonography was also used.
Main Results:
- Despite wider invasion and more extensive resections in Group I, surgical morbidity, mortality, and survival rates were similar to Group II.
- Eighteen-month recurrence rates were 44% for en bloc resection and 41% for standard resection.
- Eighteen-month survival rates were 71% for en bloc resection and 63% for standard resection.
Conclusions:
- En bloc resection is a viable and recommended aggressive surgical option for selected HCC patients with adjacent organ invasion.
- Careful patient selection is crucial for successful outcomes in aggressive resection strategies for advanced HCC.