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Diagnosis and surgical treatments of hepatocellular carcinoma with tumor thrombosis in bile duct: experience of 34 patients.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2004 May 15; Vol. 10 (10), pp. 1397-401. - Publication Year :
- 2004
-
Abstract
- Aim: Hepatocellular carcinoma (HCC) with bile duct tumor thrombosis (BDT) is a rare event. The prognosis of this type of patients is very dismal. The aim of this study was to share the experience in the diagnosis and treatment of HCC with BDT, to further improve the prognosis of these patients.<br />Methods: Thirty-four patients of HCC with BDT received surgical treatment in authors' institute from July 1987 to January 2003 were reviewed retrospectively. The experience in the diagnosis and treatment, and the outcome of this type of HCC patients were summarized.<br />Results: Thirty of the 34 patients (88.2%) were positive for alpha-fetoprotein (AFP) (>20 microg/L), and 12 patients (35.3%) were found having obstructive jaundice before operation, 18 cases were suspected of "obstruction of bile duct" preoperatively. The primary tumors were frequently located at the left medial (13 cases) or right anterior lobe (14 cases). Thirty-one patients received liver resections and removal of BDT, while the other 3 patients received removal of BDT combined with hepatic artery ligation and cannulation (HAL+HAI), or only removal of BDT because their liver function reservation and general condition could not tolerate the primary tumor resection. The 1-year survival rate was 71.4%(20/28). The longest disease-free survival was over 15 years. The intrahepatic tumor recurrence within 1 year after operation was found in 14 patients (14/28, 50.0%).<br />Conclusion: Surgical removal of primary tumors and BDT is safe and beneficial to the HCC patients with BDT. Early detection, diagnosis, and surgical treatment are the key points to prolong the survival time of patients.
- Subjects :
- Disease-Free Survival
Female
Follow-Up Studies
Humans
Jaundice, Obstructive diagnosis
Jaundice, Obstructive diagnostic imaging
Jaundice, Obstructive pathology
Jaundice, Obstructive surgery
Male
Prognosis
Radiography
Retrospective Studies
Survival Rate
Bile Duct Neoplasms diagnosis
Bile Duct Neoplasms diagnostic imaging
Bile Duct Neoplasms pathology
Bile Duct Neoplasms surgery
Carcinoma, Hepatocellular diagnosis
Carcinoma, Hepatocellular diagnostic imaging
Carcinoma, Hepatocellular pathology
Carcinoma, Hepatocellular surgery
Liver Neoplasms diagnosis
Liver Neoplasms diagnostic imaging
Liver Neoplasms pathology
Liver Neoplasms surgery
Thrombosis diagnosis
Thrombosis diagnostic imaging
Thrombosis pathology
Thrombosis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1007-9327
- Volume :
- 10
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 15133842
- Full Text :
- https://doi.org/10.3748/wjg.v10.i10.1397