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William C. Chapman, MD

Arch Surg. 2008;143(6):543.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The report by Chirica et al retrospectively analyzes the outcomes of 20 patients who underwent surgical resection of stage IVA HCC, representing 16% of the 128 patients overall who underwent surgical treatment of HCC at this center. These patients had advanced-stage disease with a median number of 3 resected tumors per patient and a median diameter of the largest tumor of 6 cm. Five patients had major portal venous involvement and 2 had associated inferior vena cava invasion that required operative reconstruction. All patients had at least severe fibrosis in the nontumor-bearing liver with 60% having biopsy-proven cirrhosis. Impressively, Chirica et al report an operative mortality rate of only 5% with a 30% morbidity rate in this group of high-risk, advanced-stage tumors.

While this report has several limitations, including the highly select, relatively small patient cohort, it nevertheless is important in demonstrating that operative resection can . . . [Full Text of this Article]

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RELATED ARTICLE

Treatment of Stage IVA Hepatocellular Carcinoma: Should We Reappraise the Role of Surgery?
Mircea Chirica, Olivier Scatton, Pierre-Philippe Massault, Thomas Aloia, Bruto Randone, Bertrand Dousset, Paul Legmann, and Olivier Soubrane
Arch Surg. 2008;143(6):538-543.
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