Hepatocellular cancer. Current trends and the results in surgical treatment

Abstract

Aim. To analyze the results of a multidisciplinary approach to the treatment of patients with hepatocellular cancer in a multidisciplinary oncology clinic.Materials and Methods. From 2007 to 2021, 259 patients with hepatocellular cancer were surgically treated in the Department of Liver and Pancreas Surgery of the city clinical hospital named after S.P. Botkin. Liver resections of different extent were performed in 74 (28.6%) patients, radiofrequency ablation – in 19 (7.3%), microwave ablation – in 20 (7.7%), hepatic artery chemoembolization with radiofrequency ablation – in 34 (13.1%), regional chemotherapy – in 104 (40.2%), liver transplantation – in 8 (3.1%) patients.Results. The overall five- and ten-year survival after liver resection was 51.4% and 31.1% respectively. The poor prognostic factors following liver resection were age >70 years (p = 0.03), postoperative complications (p = 0.04), lymph node metastases (p = 0.01), and a body mass index >30 kg/m2 (p = 0.045). Complications that developed after radiofrequency (microwave) ablation and chemoembolization of the hepatic artery with radiofrequency ablation were 5.1% and 5.8%. Within 90 days after liver resection, three (1.1%) patients died. Complications after resection developed in 18 (24.3%) cases during the same period. With metastases measuring ≤3 cm, the overall five-year survival after radiofrequency and microwave ablation was 36.8% and 35% respectively. With neoplasms measuring 3–5 cm, the best five-year survival was after hepatic artery chemoembolization and radiofrequency ablation (44.1%). The overall fiveyear survival after hepatic artery chemoembolization was 11.5%. No complications or deaths resulted from liver transplantation. With an average follow-up period of 12.5 months, none of the patients experienced disease recurrence or died.Conclusion. Using a multidisciplinary approach in a multidisciplinary oncology clinic improves the results of treating patients with hepatocellular cancer.