Slovenská chirurgia 4/2014

Surgical treatment of hepatocellular carcinoma – a group of patients and review of the literature

Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Incidence is increasing and HCC has risen to become the 5th commonest malignancy worldwide and the third leading cause of cancer-related death. Surgical treatment of hepatocellular carcinoma made a great progress in last ten years. Subjects and methods. The study was conducted at the Department of surgery of the UN LP in Košice in years 2009 – 2013. The study included 38 patients (34 men, 4 women), median age 63 years, whose treatment for hepatocellular carcinoma was surgery. Thirteen patients (34 %) underwent anatomic resection of liver. Non anatomic liver resection was performed in six cases (15,8 %). Nineteen patients under went biopsia – by laparotomy or laparoscopic access (50,2 %). One patient (2,6 %) underwent left hemihepatectomy, in two cases was done right hemihepatectomy (5,3 %). Six patients needed segmentectomy (15,8 %) and four of them had bisegmentectomy (10,5 %). Recurrence of HCC was reoperated in three cases (7,8 %). Two patients had manifestation of disease with rupture and haemoperitoneum (5,3 %). Postoperative complications were noticed in 18 %, three patients died. Conclusion. Safety of surgical resection is markedly increased because of suitable choice of patients, advantage in radiology and perioperative care. Resection of liver remains main surgical treatment, because more than 95 % of all patients with HCC are not capable for transplantation of liver.

Keywords: hepatocellular carcinoma, surgical treatment, morbidity, mortality.