STRATEGY OF TWO-STEP RESECTION FOR MASSIVE LIVER CANCER

Objective: To investigate the new approach of two-step resection of primary massive liver cancer (PLC). Methods: 10 cases of primary massive liver cancer were treated with two-step resection after marked shrinkage of the tumor by integrating radiotherapy from June 1987 to December l997. Step one: modified radiotherapy, including radiation of the whole liver by moving split fields and diminution field radiation, plus Traditional Chinese Medicine (TCM) of strengthening the spleen and regulating qi. The total dosage of the radiation was 50(60 Gy. Step two: 3(4 weeks after radiation, resecting the tumor. Results: the diameters of the masses shrinked from 11(15 cm to 6(8 cm after preoperative radiation and TCM. CT showed focus scan one hepatic portal lymph node (2 cm) and a satellite lesions around the tumor (1(3 cm) disappeared after treatment. In one AFP negative case survival cancerous cells was found. The operation did not cause death or serious postoperative complications. During followed-up, 10 cases survived more than half a year (100%), 8 more than one year (80%), 5 more than 3 years (50%), 4 more than 5 years (40%), 3 more than 7 years (30%) and 1 more than 13 years. Conclusion: The integration of moving split fields radiation of the whole liver, diminution field radiation technique, split course and TCM, followed by operation is a new approach to treat massive liver cancer .