PALLIATIVE SURGICAL-TREATMENT FOR RECURRENT AND NONRESECTABLE HEPATOCELLULAR-CARCINOMA

Of 275 patients who had a radical hepatic resection for HCC, 143 (52%) experienced recurrences. Of these 143 patients, the liver was the site of first recurrence in 130 patients (91%). The first form of therapy for recurrent patients was transarterial chemoembolization (TACE) in 82 (74%), hepatic resection in 15 (14%) and percutaneous ethanol injection in 6 (5%) of the 111 patients who received regional therapy. Post-recurrent survival rates of TACE and hepatic resection were 37%, 77% at 3 years and 17%, 77% at 5 years, respectively. Wrapping therapy was performed in seven patients, two of whom had received repeat TACE for intrahepatic recurrence; the remaining 5 were unresectable cases. After wrapping therapy, the area of previous collateral feeders was be supplied by the hepatic artery. The high level of AFP decreased dramatically. This procedure resulted in a complete response in 2 patients, a partial response in 3 and no change in 2. Overall survival was 4-54 months, and the median survival was 18 months. Two patients are still alive, 18 and 20 months after the procedure.