J.Jpn. Surg. Soc.. 79(8): 638-642, 1978

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Report on the annual meeting

SURGICAL TREATMENT OF PRIMARY LIVER CANCER WITH CIRRHOSIS

This is the study on surgical treatment of primary liver cancer with cirrhosis. 133 primary liver cancer were treated in our department. Sixty-six out of 120 operated cases were found to be combined with cirrhosis. Over all resectability was 26.7%, while 12 cases were performed hepatic resection in cirrhotic cases. These surgeries were 3 cases of three segmentectomy, 2 right lobectomy, 5 one segmentectomy, and 2 partial hepatic resections. All the three segmentectomized patients died within one month. However, the mortality of others were 22% and the longest survival was 2 years. Twentysix non-resectable cases were treated by tumor side hepatic artery ligation. Systemic chemotherapy after the ligation was not effective in cirrhotic. On the otherhand, 14 cases which were treated by infusion chemotherapy after the ligation showed more effective results even in cirrhotic patients with the longest survival of 7 months.
We conclude that two segment resection for primary liver cancer with cirrhosis will be performed unless accompanying with severe hepatic injuries. The most valuable preoperative laboratory findings for hepatic resection are ICG＜20%, serum albumin＜3.5 g/dl, ChE＜0.45 pH, S-GOT＜ 100U, PT＜ 70%, and HpT ＜ 70%. Hepatic artery ligation with regional infusion chemotherapy as a palliative treatment is useful for the non-resectable primary liver cancer, even for the cirrhotic case.

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