Hepatocellular carcinoma of the intrabiliary growth type

Background. To determine the optimal surgical therapy for patients with the intrabiliary growth type of hepatocellular carcinoma (HCC), Methods. We evaluated 257 patients with HCC who underwent liver resection from 1981 to 1990 in Kyushu University Hospital. Results. There were 13 (5.1 per cent) with the intrabiliary growth type of HCC, Total bilirubin and r-glutamyl transpeptidase levels were higher (p < 0.05), and diameter of these tumors was larger in patients with intrabiliary growth type of HCC (p < 0.05), There were significant correlations between patients with the intrabiliary growth type of HCC and intrahepatic metastasis (p < 0.01), and port;il vein infiltration (p < 0.01). Survival time of patients with the intrabiliary growth type was significantly shorter than that in the control group (p < 0.05), Nevertheless, two of three patients with the intrabiliary growth type of HCC who underwent resection of more than a 10 mm surgical margin survived for 5 years, respectively. Conclusions. A large number of patients with the intrabiliary growth type of HCC were advanced HCCs with intrahepatic metastasis or portal vein infiltration, However, we favour the view that patients have had a better prognosis if hepatectomy of more than a 10 mm surgical margin had been done.