Surgery may be option for advanced liver cancer

NEW YORK (Reuters Health) - Surgical removal of liver cancer may be a useful treatment and should at least be considered in patients with multiple tumors or vascular complications, according to a report in the journal Gastroenterology.

Current guidelines that recommend surgery only for patients with a single tumor and no vascular complications may be too strict, Dr. Norihiro Kokudo from University of Tokyo, told Reuters Health.

Kokudo and colleagues assessed the therapeutic value of surgery for liver cancers with multiple tumors and vein complications and reevaluated the treatment guidelines for liver cancer, which have been based on data obtained mainly in Western countries.

Although long-term overall survival was lower in patients with multiple tumors than in patients with single tumors, the authors report, patients with multiple tumors were still able to achieve 5-year survival rates of up to 58 percent.

Long-term overall survival was also poorer in patients with vein complications, but 5-year rates as high as 56 percent were seen, the report indicates.

Generally, it is thought that a curative treatment, such as surgery, may be considered if the 5-year survival rate exceeds 50 percent. These findings therefore support the potential use of surgery for patients with multiple tumors or vein complications.

The best results were seen in patients with relatively normal liver function, known as Child-Pugh class A. Kokudo said that patients with worse liver function (class B) may not be good candidates for surgery, but depending on tumor characteristics, such as the location, surgery may still be a valuable treatment.

SOURCE: Gastroenterology, June 2008.