Pedunculated hepatocellular carcinoma and surgical treatment

To determine the optimal surgical therapy for patients with pedunculated hepatocellular carcinoma (HC), we evaluated findings in ten patients with pedunculated HC among 350 patients with HC who underwent hepatectomy from 1975 to 1991 at Kyushu University Hospital. These patients were classified into three groups: Group I (n = 4) Pedunculated HC with no intrahepatic HC, Group II (n = 2) Pedunculated HC with a single intrahepatic HC, and Group III (n = 4) Pedunculated HC with multiple intrahepatic HC. Patients in group I and II were treated by partial hepatic resections or subsegmentectomies. In two patients there was an intrahepatic recurrence in the same lobe, after radical resection. All patients in group III who underwent palliative resection died within 8 months after surgery. Retrospectively, we favour the view that patients in Groups I or II may have had a better prognosis if lobectomy rather than partial hepatectomies had been done.