One hundred twenty cirrhotic patients underwent hepatic resection (n = 60) or transplantation (n = 60) for hepatocellular carcinoma. Overall 3-year survival and survival without recurrence were 50% and 23% in the resection group compared to 47% and 44% in the transplantation group. Several characteristics of the tumors have been studied in order to determine prognostic factors in both groups. Thus, results for 3-year survival without recurrence following transplantation in patients with tumors < 3 cm/one or two nodules (83%) were superior to those following transplantation in patients with tumors larger than 3 cm or three or more nodules (37%) (P < 0.02) and to those following resection (10%). Thus, for patients with small tumors, until now the best candidates for resection, transplantation appears to have significantly better results. Conversely, for larger lesions, with three or more nodules, transplantation, in view of the critical donor situation, is probably not indicated.

Antineoplastic Agents↗

PubMedDate not supplied

Benign and malignant tumors of the liver--introduction.

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Hepatectomy↗

PubMedDate not supplied

Cavernous hemangiomas of the liver: are there any indications for resection?

A total of 163 patients with cavernous hemangiomas of the liver were managed at Paul Brousse Hospital between 1970 and 1992. The tumor was smaller than 4 cm in 54 patients and larger than 10 cm in 38 patients. The diagnostic sensitivities of the imaging procedures were as follows: ultrasonography 61%; angio-computed tomography scanning 77%; angiography 85%; magnetic resonance imaging 92%. The tumor was diagnosed during the evaluation of abdominal pain in 87 patients. Forty-seven patients had associated disorders that proved to be responsible for the symptoms. Fourteen patients with incapacitating symptoms underwent specific treatment of their tumor: resection (n = 8), embolization (n = 5), or hepatic artery ligation (n = 1). Seven of these patients are still symptomatic, indicating that the hemangioma was in fact not responsible for their symptoms. Twenty-five patients were given oral analgesic medications; in 21 the symptoms diminished or became infrequent. Unresected hemangiomas did not significantly increase in size, nor have they become complicated or symptomatic. These results indicate that resection of liver hemangiomas is rarely required, and such treatment should be carefully balanced against the risk inherent in liver surgery.

Adult↗