[Advanced hepatocellular carcinoma: therapeutic results in 110 patients and therapeutic strategy]

The prognoses of 110 patients with advanced hepatocellular carcinoma (HCC) in stages III and IV were studied retrospectively. These patients were treated mainly by transarterial chemoembolization (TAE) or chemoinfusion using Lipiodol. Some of the patients underwent percutaneous ethanol injection therapy (PEIT) or tumor resection following TAE. Hepatic function, tumor stage, vascular involvement, type of tumor invasion, number of tumors and number of treatments affected the prognosis of the patients. The prognosis was better in the Child A group than in Child B and C. In the Child C group, the prognosis was markedly poor, and was least affected by any treatment. The prognoses in the patients with multiple nodular lesions, massive or diffuse lesions, were much poorer than those with a few nodular lesions. Tumor thrombosis in the central portal vein and distant metastasis greatly exacerbated the therapeutic results. Repeat therapy yielded a favorable therapeutic result when hepatic function was tolerable. Surgical intervention and PEIT were an effective therapy in a few patients. In advanced HCC, liver function and tumor extension should be fully evaluated, and it is important to determine the most effective therapeutic modalities to improve the survival of patients.