Exploring the role of resection of extrahepatic metastases from hepatocellular carcinoma

Abstract The role of hepatic resection, taking into consideration the functional status of the liver, for localized hepatocellular carcinoma (HCC) is an established curative treatment. In advance disease, a variety of interventional-based liver-directed therapies and more recently systemic therapy w...

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Bibliographic Details
Published in:Surgical oncology 2012-06, Vol.21 (2), p.95-101
Main Authors: Chua, Terence C, Morris, David L
Format: Article
Language:English
Subjects:
Abdomen
Adrenal Gland Neoplasms - secondary
Adrenal Gland Neoplasms - surgery
Adrenal glands
Adrenalectomy
Bone metastases
Bone Neoplasms - secondary
Bone Neoplasms - surgery
Cancer therapies
Carcinoma, Hepatocellular - secondary
Carcinoma, Hepatocellular - surgery
Chemotherapy
Fatalities
Hematology, Oncology and Palliative Medicine
Hepatocellular carcinoma
Humans
Liver cancer
Liver Neoplasms
Lung metastases
Lung Neoplasms - secondary
Lung Neoplasms - surgery
Lymphadenectomy
Lymphatic Metastasis
Lymphatic system
Medical imaging
Metastasectomy - methods
Musculoskeletal system
Neoplasm Metastasis
Peritoneal metastases
Peritoneal Neoplasms - secondary
Peritoneal Neoplasms - surgery
Pulmonary metastasectomy
Radiation therapy
Studies
Surgery
Tomography
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Summary:Abstract The role of hepatic resection, taking into consideration the functional status of the liver, for localized hepatocellular carcinoma (HCC) is an established curative treatment. In advance disease, a variety of interventional-based liver-directed therapies and more recently systemic therapy with sorafenib are available to treat unresectable tumors. Extrahepatic Metastasis (EHM) of HCC may occur at initial diagnosis or during recurrence following treatment. This may occur with or without concurrent intrahepatic disease. We reviewed the published works on surgical metastasectomy for common sites of EHM of HCC metastases. It appears from the studies reported in the literature that from selected cases reported, long-term survival may be achieved from resecting metastasis at sites of the abdominal lymph node, adrenal gland, lung, and peritoneum. The encouraging results presented demonstrate that highly selected fit patients may be suitable candidates for these radical curative pursuits. It is likely that indications for resection of EHM HCC may benefit patients with limited isolated metastasis, who have a preserved liver function, and whose primary tumor has been adequately controlled. A registry study to pull the results of case reports and institutional experiences may be useful in cumulating evidence of this practice.
ISSN:0960-7404
1879-3320
DOI:10.1016/j.suronc.2011.01.005