J.Jpn. Surg. Soc.. 79(8): 654-657, 1978

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Report on the annual meeting

TREATMENT FOR CIRRHOTIC LIVER CANCER

During a twenty-seven year period from July 1951 to March 1978, 118 patients with histologically proved primary cancer of the liver were admitted to our department. Of 118 cases, 42 patients were clearly associated with cirrhosis; 40 patients with hepatoma and 2 with cholangioma. Hepatic resection was carried out in 17 patients with cirrhosis; 2 had extended right hepatic lobectomy, 3 had right hepatic lobectomy, and 5 had left lateral segmentectomy. There were three operative deaths. Although the survival was not good, one of the patients with cirrhosis survived 17 years and 5 months after left lateral segmentectomy.
Although directly related to the massive mass of liver resection, the risk of liver resection is relatively low in patients with normal remaining liver. When liver function is compromised with associated cirrhosis, however, the risk of operation is significantly increased. It was emphasized that patients should have both a normal or parabolic GTT pattern and normal insulin secretion from the pancreas after a glucose load, and have cytochrome a(+a) contents of 0.8-1.3 × 10^-10 mole/mg protein in the mitochondria from the remnant liver, as the best way of judging the capacity of the remnant to enable the patient to survive a major hepatic resection.

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