J.Jpn. Surg. Soc.. 79(8): 643-647, 1978

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Report on the annual meeting

TREATMENTS OF HEPATOMA WITH ASSOCIATED CIRRHOSIS

During the recent 10 years, 105 patients of hepatoma were admitted to our clinic. Sixty-six had associated cirrhosis and four fibrosis of the liver. The therapeutic results of these 70 patients were analyzed according to the mode of therapy. The mean survival period (M±SE) after admission were as follow; no treatment group (12 cases) 39±14 days, systemic chemotherapy group (12) 99±20 days, hepatic arterial one shot infusion of MMC group (8) 94±41 days, continuous infusion of mainly 5-FU into hepatic artery group (5) 139±58 days, hepatic artery ligation with following chemotherapy group (16) 168±35 days.
Hepatic resection was carried out in 17 patients; partial hepatectomy in 5, left lateral segmentectomy in 1, left lobectomy in 3, right lobectomy in 8. Eight patients are living from 7 months to 3 years after operation. Four died of recurrence of hepatoma 4 months to 3 years and 3 months after resection. Two died of hepatic failure, two of fatal infection, and one of massive bleeding from duodenal ulcer within 70 days. The loading test with ICG of remaining liver by temporary clamping of the inflow of the liver to be removed during surgery was found to be a useful index to know if or not the contemplated resection is safely undertaken, with 40% of R₁₅ being a limit in cirrhotic patients.
The result indicated that hepatic resection, from partial to extended, might be possible even with cirrhosis but the more certain selection of patients for resection is to be solved.

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