Current approaches to surgical treatment of liver tumors

• Published in: Voprosy onkologij Vol. 44; no. 5; p. 580
• Main Authors: Patiutko, Iu I, Sagaĭdak, I V, Kotel'nikov, A G, Badalian, Kh V, Tumanian, A O
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 1998
• Subjects: Adjuvants, Immunologic - therapeutic use; Antimetabolites, Antineoplastic - therapeutic use; Antineoplastic Agents - therapeutic use; Chemotherapy, Adjuvant; Combined Modality Therapy; Female; Fluorouracil - therapeutic use; Hemostasis, Surgical; Hepatectomy; Humans; Interferon Type I - therapeutic use; Interferon-alpha; Laser Coagulation; Leucovorin - therapeutic use; Liver Failure - mortality; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Postoperative Care; Postoperative Complications - mortality; Prognosis; Recombinant Proteins; Reoperation; Time Factors; Ultrasonic Therapy
• ISSN: 0507-3758

Since 1990, 230 operations for focal pathologies in the liver have been carried out at the Center's clinics using such advanced procedures and equipment as radio-isotope examination of hepatic function, ultrasonography of the liver during surgery, ultrasound aspirator, water-flow scalpel, argon coagulator and adhesive dressing materials. The study included 75 resections for primary hepatic tumor (lethality-14.6%), 114 resections-disseminated tumor (lethality-5.2%) and 41 resections for benign tumors and non-tumor pathologies (no lethality). Preoperative chemotherapy was found to significantly increase the risk of postoperative complications in cases of liver resection. Five-year survival in such patients with primary tumor was 33.3%. The seven most significant prognostic factors in primary hepatic carcinoma were: portal invasion by tumor cells, number of tumor nodes in the liver, alpha-fetoprotein concentration, tumor node size, concomitant cirrhosis, age and extent of surgery. In patients with hepatic resection for solitary metastasis of the large bowel, 5-year survival was 28.6%. A regimen of adjuvant chemotherapy for solitary metastasis of colorectal cancer into liver is suggested. The data on 37 surgical patients with hepatic metastasis of non-colorectal cancer are presented. It was demonstrated that the liver should be resected in cases of solitary metastasis of renal carcinoma, adrenal gland, ovary, tests, breast, gallbladder and carcinoid.