ABSTRACT
The case was a 70-year-old man of highly advanced gastric cancer with 2 liver metastases(S3, S8)and pancreatic invasion. Three courses of S-1 plus L-OHP(SOX therapy)were performed, and total gastrectomy and combined resection of the spleen and body and tail of the pancreas and partial resection of the liver S3 and S8 were performed after reduction of primary tumor and liver metastasis. S-1 therapy was continued for 1 year as postoperative adjuvant chemotherapy. Left adrenal metastasis was detected by CT, 1 year and 6 months after the operation. PET-CT revealed no other areas suspected of recurrence, so left adrenalectomy was performed through the retroperitoneal space. Radical resection was not achieved because adhesions and scarring from the previous surgery were severe. Paclitaxel plus Ramucirumab was started and after 10 courses, the disappearance of the tumor shadow was observed on enhanced CT, and PET-CT. Three years and 3 months after the initial surgery and 1 year and 8 months after resection of adrenal metastasis, the patient is alive without recurrence.
Subject(s)
Liver Neoplasms , Stomach Neoplasms , Aged , Humans , Adrenalectomy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Gastrectomy , Liver Neoplasms/drug therapy , Liver Neoplasms/surgery , Liver Neoplasms/secondary , Positron Emission Tomography Computed Tomography , Stomach Neoplasms/drug therapy , Stomach Neoplasms/surgery , Stomach Neoplasms/pathology , MaleABSTRACT
PURPOSE: Postoperative venous thromboembolism (VTE) is a major and potentially fatal postoperative complication of colorectal cancer surgery. However, there is uncertainty about the necessity for anticoagulant prophylaxis to prevent VTE after laparoscopic colorectal cancer surgery because of its associated relatively lower incidence. Currently, anticoagulant therapy is considered mainly for patients at high risk of the development of VTE. Focusing on proximal deep vein thrombosis (DVT)/ pulmonary embolism (PE), we aimed to identify those cases at high risk of the development of fatal VTE. METHODS: We performed an exploratory retrospective analysis to identify the risk factors for postoperative proximal DVT and PE after laparoscopic colorectal cancer surgery in patients included in our prospective trial. RESULTS: A logistic regression analysis revealed factors that could predict the onset of proximal DVT/PE in patients with colorectal cancer. Blood loss and tumor location were identified as the predictors of proximal DVT/PE. CONCLUSIONS: Patients with rectal cancer and those with excessive blood loss during colon cancer surgery must be monitored carefully for signs of VTE and especially proximal DVT/PE, after laparoscopic surgery.
Subject(s)
Colorectal Neoplasms , Laparoscopy , Pulmonary Embolism , Venous Thromboembolism , Venous Thrombosis , Anticoagulants/therapeutic use , Colorectal Neoplasms/complications , Humans , Laparoscopy/adverse effects , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Prospective Studies , Pulmonary Embolism/epidemiology , Pulmonary Embolism/etiology , Pulmonary Embolism/prevention & control , Retrospective Studies , Risk Factors , Venous Thromboembolism/epidemiology , Venous Thrombosis/epidemiology , Venous Thrombosis/etiology , Venous Thrombosis/prevention & controlABSTRACT
An 83-year-old man visited our hospital for vomiting. Chest-abdominal computed tomography(CT)revealed that a tumor whose inside was imaged in the jejunum about 15 cm after leaving the Treitz ligament was pointed out, and dilation of the oral intestinal tract of the tumor was observed. Upper gastrointestinal endoscopy showed a type 3 circumferential tumor at the jejunum. He was diagnosed with obstructive ileus due to jejunal cancer. Laparoscopic-assisted partial jejunal resection was performed. Although the patient was followed up without chemotherapy, CT showed multiple lung and liver metastases and a mass lesion was found in the right entire chest, and a biopsy revealed skin metastasis 6 months after the operation. The patient is being followed up 10 months after surgery, there is no progression of liver, lung, and skin metastasis.
Subject(s)
Ileus , Intestinal Obstruction , Jejunal Neoplasms , Laparoscopy , Aged, 80 and over , Biopsy , Humans , Ileus/etiology , Ileus/surgery , Intestinal Obstruction/surgery , Jejunal Neoplasms/complications , Jejunal Neoplasms/surgery , MaleABSTRACT
A 63-year-old underwent examination for constipation and was found to have an unresectable advanced rectal cancer. Metastatic abdominal aortic bifurcation lymph node and lung metastasis were suspected upon CT(cT3N3M1a[PUL1], cStage â £a), and chemotherapy was administered(CapeOX plus Bmab). After 4 courses of chemotherapy, the size of the primary tumor and the lymph nodes decreased(PR). We performed laparoscopic rectum resection and abdominal aortic bifurcation lymph node. The pathological diagnosis indicated partial response(residual cancer cells)(Grade 1a). After 4 courses of chemotherapy(CapeOX), we performed pulmonary partial resection for metastatic lung cancer. This case suggests that laparoscopic resection of rectum after chemotherapy with CapeOX plus Bmab for locally advanced rectal cancer is a potential- ly effective procedure.
Subject(s)
Laparoscopy , Rectal Neoplasms , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Lymph Nodes , Lymphatic Metastasis , Middle Aged , Rectal Neoplasms/drug therapy , Rectal Neoplasms/surgery , RectumABSTRACT
A 78-year-old woman visited our hospital for a tumor in her left breast with discharge. The 10 cm tumor had ulceration and foul smell. Scirrhous breast carcinoma was diagnosed based on core-needle biopsy findings. Chest and abdominal computed tomography( CT) revealed the tumor invading the pectoralis major muscle and a large number of swollen lymph nodes from the left axilla to the subclavian region, but no distant metastases. After 6 months of locally advanced breast cancer treatment with abemaciclib and fulvestrant, ulceration improved. CT revealed that the tumor and lymph nodes tended to shrink. Left mastectomy with axillary lymph node dissection and combined resection of pectoralis major muscle was performed. Postoperative pathological histology revealed ypT2, ypN0, ypM0, ypStage â ¡A. Subsequently, abemaciclib plus fulvestrant therapy was continued as an adjuvant therapy. The patient has survived without recurrence 6 months after the operation. We report a case of locally advanced breast cancer in which abemaciclib and fulvestrant were effective.
Subject(s)
Breast Neoplasms , Aged , Aminopyridines , Axilla , Benzimidazoles , Breast Neoplasms/drug therapy , Breast Neoplasms/surgery , Female , Fulvestrant , Humans , Lymph Node Excision , Lymph Nodes , Mastectomy , Neoplasm Recurrence, LocalABSTRACT
Symptomatic colorectal cancer in extremely elderly patients is difficult to treat. A 97-year-old woman was initially suspected of having appendicitis because of worsening right lower abdominal pain with persistent fatigue. After antimicrobial therapy, advanced cecum cancer with lymph node involvement was found. Palliative laparoscopy-assisted ileocecal resection without radical lymph node dissection was performed to prevent further inflammation. The patient was transferred to another hospital for rehabilitation on postoperative day 24, when she regained walking function. This palliative procedure can be an effective treatment for elderly patients with symptomatic advanced colon cancer.
Subject(s)
Appendicitis , Cecal Neoplasms , Laparoscopy , Aged , Aged, 80 and over , Cecal Neoplasms/surgery , Cecum , Female , Humans , Lymph Node ExcisionABSTRACT
A 62-year-old man with diarrhea and metastases was found to harbor 2 rectal cancers. Both lateral lymph nodes were suspected based on CT and PET-CT(cT3N3M0, cStage â ¢b). We planned to administer neoadjuvant chemotherapy(NAC) (CapeOX plus Bmab). After 4 courses of NAC, the sizes of both the primary tumor and lymph nodes decreased(partial response: PR). We performed laparoscopic abdominoperineal resection of the rectum(APR)with dissection of both lateral lymph nodes. The therapeutic effect was PR(few residual cancer cells)(Grade 2). After 4 courses of adjuvant chemotherapy (CapeOX), there have been no signs of recurrence for 8 months. This case suggests that laparoscopic APR after NAC with CapeOX plus Bmab for locally advanced rectal cancer is a potentially effective procedure.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Rectal Neoplasms , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Laparoscopy , Lymph Node Excision , Male , Middle Aged , Neoadjuvant Therapy , Neoplasm Recurrence, Local , Positron Emission Tomography Computed Tomography , Rectal Neoplasms/diagnostic imaging , Rectal Neoplasms/drug therapy , Rectal Neoplasms/surgery , RectumABSTRACT
INTRODUCTION: The indications for duodenal stent placement for gastric outlet obstruction caused by gastric cancers remain controversial. We report the case of a patient with inoperable advanced gastric cancer with gastric outlet obstruction in whom oral intake could be prolonged for more than 2 years by duodenal stenting. A 60-year-old man diagnosed as having cStage â £ gastric cancer with liver, peritoneum, and lymph node metastases underwent duodenal stent placement before first-line chemotherapy. After 8 months, the duodenal stent was found to be dislocated in the horizontal part of the duodenum due to tumor shrinkage. It was removed immediately by endoscopy. The patient was able to take a solid diet orally for the next 19 months, while receiving systemic chemotherapy. CONCLUSIONS: Duodenal stent placement proved useful in a patient who showed response to chemotherapy, despite the need for management of late complications. This approach is expected to be a first-line treatment option for gastric outlet obstruction caused by inoperable gastric cancer.
Subject(s)
Duodenum , Gastric Outlet Obstruction/therapy , Stents , Stomach Neoplasms/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Gastric Outlet Obstruction/etiology , Humans , Male , Palliative Care , Stomach Neoplasms/complications , Stomach Neoplasms/pathology , Time FactorsABSTRACT
A man in his 60's was admitted to our hospital because of right lower abdominal pain. We diagnosed acute appendicitis with an abscess, and he was treated with laparoscopic-assisted appendectomy. The histopathological diagnosis was a goblet cell carcinoid (GCC) of the appendix. Because of the possibility of lymph node metastasis, the patient underwent laparoscopic- assisted ileo-cecum resection with lymph node dissection (D2). Metastasis was detected in one of the dissected lymph nodes. This patient has been followed-up for a year after surgery and no recurrences have been detected.
Subject(s)
Abdominal Abscess/diagnosis , Abdominal Pain/etiology , Appendiceal Neoplasms/diagnosis , Appendicitis/diagnosis , Carcinoid Tumor/diagnosis , Diagnosis, Differential , Abdominal Abscess/surgery , Appendectomy , Appendiceal Neoplasms/pathology , Appendiceal Neoplasms/surgery , Appendicitis/surgery , Carcinoid Tumor/surgery , Humans , Lymph Node Excision , Lymphatic Metastasis , MaleABSTRACT
A 71-year-old man was admitted to our hospital for epigastric pain. Upper gastrointestinal endoscopy revealed a type 2- like ulcerative lesion in the posterior wall of the upper and middle part of the stomach. Endoscopic biopsies showed malignant T-cell lymphoma histologically. A chest CT scan revealed a nodule in the apex of right lung, suggestive of primary lung cancer. A total gastrectomy with D2 lymphadenectomy and distal pancreatectomy with splenectomy was performed. Seventy-three days after surgery, the patient developed a lung abscess in the middle lobe of the right lung. A wedge-shaped resection of the upper lobe and total resection of the middle lobe of the right lung was performed. Histological examination revealed a primary pulmonary mucosa-associated lymphoid tissue lymphoma in the upper lobe of right lung and an abscess caused by Pseudomonas aeruginosa in the middle lobe of the right lung. Twelve months after surgery the man died of suffocation because of aspiration due to esophageal stenosis caused by progression of metastasis of the paraesophageal lymph node.
Subject(s)
Lung Neoplasms/pathology , Lymphoma, B-Cell, Marginal Zone/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Neoplasms, Multiple Primary/diagnosis , Stomach Neoplasms/diagnosis , Aged , Gastrectomy , Humans , Lung Neoplasms/surgery , Lymphoma, B-Cell, Marginal Zone/surgery , Lymphoma, Non-Hodgkin/surgery , Male , Neoplasms, Multiple Primary/surgery , Pancreatectomy , Stomach Neoplasms/surgeryABSTRACT
A 68-year-old man diagnosed with type 0-â gastric cancer by gastrointestinal endoscopy underwent urgent distal gastrectomy due to a perforation during endoscopic submucosal resection. Pathological examination revealed pT3N2M0, pStage â ¢A. TS-1 was administered as adjuvant chemotherapy. Laboratory examinations 10 months after surgery revealed leukocytosis (19,100/mL). Positron emission tomography-CT demonstrated metastases in the bone marrow and ascending colon as well as around the liver. Chemotherapy using nab-PTX had poor efficacy and the leukocytosis worsened. Serum granulocyte- colony stimulating facto (r G-CSF) was high at 1,640 pg/mL, and immunohistochemical staining was positive for G-CSF. Thus, the patient was diagnosed with G-CSF-producing gastric cancer. The tumor was also positive for HER2 antibody by immunohistochemical staining. Combination therapy using TS-1 plus CDDP plus trastuzumab resulted in a good response, and the leukocytosis and elevated serum G-CSF gradually improved. The patient is living 30 months postoperatively and remains on chemotherapy.
Subject(s)
Granulocyte Colony-Stimulating Factor/biosynthesis , Stomach Neoplasms/drug therapy , Trastuzumab/therapeutic use , Aged , Gastrectomy , Humans , Male , Multimodal Imaging , Positron-Emission Tomography , Prognosis , Stomach Neoplasms/metabolism , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
An 81-year-old woman was admitted for leg edema. She was found to have membranous glomerulonephritis with advanced gastric cancer after renal biopsy and endoscopic examination. Serum albumin was 1.4 g/dL and total protein was 4 g/dL on admission. After albumin was administered, distal gastrectomy was performed. Albumin administration continued post-operatively. The post-operative course was unremarkable and she was discharged on post-operative day 19. Six months after the operation, serum albumin gradually increased and uric protein volume decreased. Possible remission of membranous glomerulonephritis with gastric cancer can be expected after gastrectomy but careful perioperative management is required.
Subject(s)
Adenocarcinoma/complications , Glomerulonephritis, Membranous/etiology , Stomach Neoplasms/complications , Adenocarcinoma/surgery , Aged, 80 and over , Biopsy , Female , Gastrectomy , Humans , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Treatment OutcomeABSTRACT
The patient was an 86-year-old woman. She underwent right breast-conserving surgery and sentinel lymph node biopsy for breast cancer in August 2006. The pathological diagnosis was invasive ductal carcinoma, T1N0M0, Stage â , ER (+), PgR (-), HER2 (-). She was treated with tamoxifen for 5 years as adjuvant therapy and showed no signs of recurrence. In November 2014, CA15-3 was elevated and an accumulation of FDG in the right paracolic sulcus was observed on PET-CT. Peritoneal metastasis of breast cancer was suspected, and an operation was performed for a definitive diagnosis. During the operation, the tumor was seen on the paracolic sulcus, and laparoscopic-assisted right hemicolectomy was performed. A poorly differentiated adenocarcinoma was diagnosed by pathological examination, and immunostaining results were as follows: CK7(+), CK20(-), mammaglobin (-), GCDFP-15 (-), ER (-), PgR (-), and HER2 (-). Because there was no original lesion other than the breast cancer, the tumor was diagnosed as a metastasis of breast cancer. The frequency of peritoneal metastasis of breast cancer is low. In this case, pathological diagnosis was necessary for a definitive diagnosis. A change of subtype was also confirmed, and the treatment strategy was decided appropriately. Surgical resection should be considered for peritoneal metastasis of breast cancer when the operation can be performed safely.
Subject(s)
Adenocarcinoma/surgery , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoma, Ductal/surgery , Peritoneal Neoplasms/secondary , Peritoneal Neoplasms/surgery , Aged, 80 and over , Antineoplastic Agents, Hormonal/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Carcinoma, Ductal/drug therapy , Colectomy , Female , Humans , Laparoscopy , Recurrence , Tamoxifen/therapeutic use , Tegafur/therapeutic use , Uracil/therapeutic useABSTRACT
In the EMBRACE trial, eribulin was reported to significantly increase overall survival compared to treatment of the physician 's choice when given to patients with recurrent or metastatic breast cancer who had received prior treatment, including an anthracycline and a taxane. In April 2011, eribulin was approved in Japan for the treatment of inoperable or recurrent breast cancer. In this article, we report on the efficacy and safety of eribulin in cases we encountered. Twenty patients with advanced and recurrent breast cancer were administered eribulin in our hospital during the period from August 2011 to December 2012. The median age was 62 years(range, 42-76 years); 16 patients had the estrogen receptor(ER)(+)/human epidermal growth factor receptor 2(HER2)(-)subtype, whereas 4 patients had the triple-negative subtype. Following recurrence, the median number of chemotherapy regimens was 3(range, 0-5). Regarding the antitumor effects of eribulin, no cases showed complete response(CR), 5 cases showed partial response(PR), and 10 cases showed stable disease(SD); therefore, the response rate(CR+PR)was 25% and the clinical benefit rate(CR+PR+B6-month SD)was 35%. Median progression free survival was 146 days, and median overall survival was 482 days. In terms of adverse events(AEs), observed cases of hematotoxicity were of neutropenia(75%), leucopenia(75%), and anemia(80%). Cases of Grade 3 hematotoxicity or higher were of neutropenia(40%), leucopenia(20%), and febrile neutropenia(1 case, 5%). The observed non-hematotoxic AEs were peripheral neuropathy(30%)and general malaise(35%), although none were of Grade 3 or higher. The therapeutic efficacy of eribulin in the present study was relatively better than that in previous reports(EMBRACE trial, Japan Domestic 221 trial). The frequency of Grade 3 or higher AEs was low, and the drug was well tolerated. We believe that eribulin is a novel drug that provides therapeutic efficacy while maintaining quality of life(QOL).
Subject(s)
Breast Neoplasms/drug therapy , Furans/therapeutic use , Ketones/therapeutic use , Adult , Aged , Breast Neoplasms/pathology , Furans/adverse effects , Humans , Ketones/adverse effects , Middle Aged , Neoplasm Metastasis , Recurrence , Treatment OutcomeABSTRACT
A 94-year-old woman with a distended abdomen was transferred to our hospital.Based on the enhanced abdominal computed tomographic (CT) finding, she was diagnosed with colonic obstruction due to sigmoid cancer. Colonoscopy was performed to make definitive and qualitative diagnoses, and to release the stenosis using a self-expanding metallic stent (SEMS). The SEMS was inserted without complication.On the fifth day after the decompression, the patient underwent laparoscope-assisted sigmoidectomy with lymph node resection.Despite the colon obstruction, a primary anastomosis was performed.The operation time was 163 min, and 3 mL of blood was lost.The patient was discharged without complications. We describe the case of a bridge to surgery in a very elderly patient. A bridge to surgery can be an effective option for the treatment of colon obstruction in non-elderly and very elderly patients.
Subject(s)
Ileus/surgery , Sigmoid Neoplasms/surgery , Aged, 80 and over , Female , Humans , Ileus/etiology , Neoplasm Staging , Sigmoid Neoplasms/complications , Sigmoid Neoplasms/pathology , Stents , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 39-year-old woman was referred to our hospital with a history of fecal occult blood.She was diagnosed with advanced sigmoid colon cancer.A colonoscopy indicated a stenosis, and an enhanced abdominal computed tomography (CT) scan revealed liver metastasis.The patient was operated on for a total of 337 minutes, and an estimated 35 mL of blood was lost. This is the shortest operating time and lowest amount of blood loss of which we are aware.Although an intra-abdominal abscess occurred, the patient recovered well and was discharged on postoperative day 25.Herein, we describe the case of a patient who underwent simultaneous laparoscopic resection of sigmoid colon cancer and a synchronous liver metastasis.We also review the efficacy of simultaneous laparoscopic resection of colorectal cancer and synchronous liver metastasis in this report.
Subject(s)
Laparoscopy , Liver Neoplasms/surgery , Sigmoid Neoplasms/surgery , Adult , Chemotherapy, Adjuvant , Colectomy , Female , Hepatectomy , Humans , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Sigmoid Neoplasms/drug therapy , Sigmoid Neoplasms/pathologyABSTRACT
A-64-years-old woman with locally advanced rectal cancer, which had invaded the vagina, was referred to our hospital. She was administered neoadjuvant chemotherapy to reduce the tumor size. After 4 courses of chemotherapy consisting of folinic acid, fluorouracil, and oxaliplatin (mFOLFOX6), an enhanced computed tomography (CT) scan and magnetic resonance imaging (MRI) indicated marked tumor shrinkage. We performed a laparoscopically assisted low anterior resection, which included total mesorectal resection, resection of the vaginal posterior wall, and right lateral lymph node resection. The chemotherapy prevented us from having to create a permanent colostomy. The efficacy of the neoadjuvant chemotherapy was Grade 1b. We experienced a case of neoadjuvant chemotherapy followed by curative resection.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoadjuvant Therapy , Rectal Neoplasms/drug therapy , Vagina/pathology , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Female , Fluorouracil/administration & dosage , Humans , Laparoscopy , Leucovorin/administration & dosage , Middle Aged , Neoplasm Invasiveness , Organoplatinum Compounds/administration & dosage , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Vagina/surgeryABSTRACT
A 60-year-old man with unresectable colon cancer required treatment for hydronephrosis, acute cholecystitis, and obstructive jaundice before chemotherapy. His performance status (PS) gradually deteriorated to PS 4. Cetuximab monotherapy was initiated instead of intensive chemotherapy. His general condition improved and mFOLFOX7 therapy was then continued in addition to cetuximab. A computed tomography (CT) scan after 6 months of chemotherapy revealed a partial response (PR). Cetuximab monotherapy may contribute to the treatment of patients with a poor PS.
Subject(s)
Adenocarcinoma/drug therapy , Antibodies, Monoclonal, Humanized/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colonic Neoplasms/drug therapy , Liver Neoplasms/drug therapy , Adenocarcinoma/secondary , Cetuximab , Colonic Neoplasms/pathology , Humans , Liver Neoplasms/secondary , Male , Middle Aged , Neoplasm Staging , Treatment OutcomeABSTRACT
A 60-year-old man presenting with dysphagia was referred to our hospital with a diagnosis of esophageal cancer and gastric cancer. Upper gastrointestinal endoscopy revealed type 2 tumors in the upper thoracic esophagus and in the lesser curvature of the angular incisure, and elevated lesions in the duodenum and in the transverse colon. Laryngoscopy revealed erosion of the right vocal cord. Computed tomography (CT) of the chest revealed a nodule in the middle lobe of the right lung. Laryngomicro surgery was performed for the right vocal cord erosion, and it was diagnosed as carcinoma in situ. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) were performed for the lesions in the duodenum and in the transverse colon, respectively; the lesions were diagnosed as adenocarcinoma in adenoma. After 2 courses of neoadjuvant chemotherapy with the 5-fluorouracil (5-FU), cisplatin, and Adriamycin (FAP) regimen, subtotal esophagectomy with reconstruction of the pedunculated jejunum through the antethoracic route, total gastrectomy, and resection were performed on the right middle lobe of lung. Pathological examination revealed esophageal cancer (fT4N0M0, fStageIII), gastric cancer (ypT3N0M0, pStageIIA), and primary pulmonary adenocarcinoma (pT1bN1M0, pStageIIA). After surgery, the patient was treated with chemoradiotherapy (60 Gy, with 2 courses of 5-FU plus cisplatin [FP]), and 6 months after the operation, he was in good health without recurrence.
Subject(s)
Neoplasms, Multiple Primary/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Humans , Male , Middle AgedABSTRACT
Laparoscopic hepatectomy has been reported as a safe and effective approach for the treatment of hepatocellular carcinoma ( HCC). However, few studies have reported survival outcomes after laparoscopic hepatectomy in HCC patients with cirrhosis. In the present study, we evaluated the surgical outcomes and disease-free survival in these cases. Between June 2010 and March 2013, 35 HCC patients with cirrhosis underwent laparoscopic hepatectomy. Operative variables for laparoscopic vs open hepatectomy were as follows: operative times, 268.3 vs 183.3 minutes (p=0.0043); blood loss volume, 151.0 vs 1,106.1 g (p<.001); 1-year disease-free survival rate, 73.1 vs 71.6%; and 2-year disease-free survival rate, 39.9% vs 28.6% (p=0.568), respectively. Laparoscopic hepatectomy is feasible and safe in selected patients with liver cirrhosis, with similar outcomes in disease-free survival when compared with open hepatectomy.