[Results of hepatectomy for huge primary liver carcinoma]

From 1964 to 1991, 166 cases of huge primary liver carcinoma (larger than 10 cm in diameter) had been resected in our department. One hundred and forty-four cases were male and 22 cases were female. The tumor was located in the left lobe of the liver in 75 cases, in the right lobe in 75 cases and in both lobes in 16 cases. The tumors were 10 to 14.9 cm in diameter in 109 cases, 15 to 20 cm in 45 cases, larger than 20 cm 12 cases. The largest tumor was 28 x 26 cm in size. In this series, most of the tumors were hepatocellular carcinoma (93.4%). The livers in 125 cases (75.3%) were associated with cirrhosis. Ten cases of them underwent regular hepatectomy. 156 cases underwent irregular hepatectomy. During the operation interrupted matress sutures, hepatic clamp, occlusion of the circulation of the hepatoduodenal ligament and microwave coagulation were employed to reduce blood loss. In this series, 95 cases underwent radical resection and 75 cases palliative resection. The post-operative complications were jaundice and ascites in 18 cases, wounds infection in 7 cases and right pleural effusion in 7 cases. Three cases died within 1 month after hepatectomy with an operative mortality of 1.8%. In our study, 64 cases had been followed up over 5 years. The 5-year survival rate of the radical resection group were 17.5%. All of the 67 patients who underwent palliative resection died 2 to 36 months after hepatectomy with a median survival time of 7 months. The biological characteristics of huge primary liver carcinoma and the approach to improve the prognosis were discussed.