BACKGROUND: To determine the optimal surgical therapy for patients with the intrabiliary growth type of hepatocellular carcinoma (HCC). METHODS: We evaluated 257 patients with HCC who underwent liver resection from 1981 to 1990 in Kyushu University Hospital. RESULTS: There were 13 (5.1 per cent) with the intrabiliary growth type of HCC. Total bilirubin and r-glutamyl transpeptidase levels were higher (p < 0.05), and diameter of these tumors was larger in patients with intrabiliary growth type of HCC (p < 0.05). There were significant correlations between patients with the intrabiliary growth type of HCC and intrahepatic metastasis (p < 0.01), and portal vein infiltration (p < 0.01). Survival time of patients with the intrabiliary growth type was significantly shorter than that in the control group (p < 0.05). Nevertheless, two of three patients with the intrabiliary growth type of HCC who underwent resection of more than a 10 mm surgical margin survived for 5 years, respectively. CONCLUSIONS: A large number of patients with the intrabiliary growth type of HCC were advanced HCCs with intrahepatic metastasis or portal vein infiltration. However, we favour the view that patients have had a better prognosis if hepatectomy of more than a 10 mm surgical margin had been done.
BACKGROUND: To determine the optimal surgical therapy for patients with the intrabiliary growth type of hepatocellular carcinoma (HCC). METHODS: We evaluated 257 patients with HCC who underwent liver resection from 1981 to 1990 in Kyushu University Hospital. RESULTS: There were 13 (5.1 per cent) with the intrabiliary growth type of HCC. Total bilirubin and r-glutamyl transpeptidase levels were higher (p < 0.05), and diameter of these tumors was larger in patients with intrabiliary growth type of HCC (p < 0.05). There were significant correlations between patients with the intrabiliary growth type of HCC and intrahepatic metastasis (p < 0.01), and portal vein infiltration (p < 0.01). Survival time of patients with the intrabiliary growth type was significantly shorter than that in the control group (p < 0.05). Nevertheless, two of three patients with the intrabiliary growth type of HCC who underwent resection of more than a 10 mm surgical margin survived for 5 years, respectively. CONCLUSIONS: A large number of patients with the intrabiliary growth type of HCC were advanced HCCs with intrahepatic metastasis or portal vein infiltration. However, we favour the view that patients have had a better prognosis if hepatectomy of more than a 10 mm surgical margin had been done.