Diagnosis And Treatment Of 22 Patients With Extrahepatic Growing Hepatocellular Carcinoma

Objective:To investigate the prognostic factors of exhepatic growing hepatocellular carcinoma and explore the diagnostic and therapeutic approaches to improve the outcome of the EGHCC.Method:A retrospective review was conducted on 22 cases of EGHCC which were pathologically diagnosed from January 1996 to Feburary 2009 at 2^nd Xiangya Hospital of CSU,with respect to the clinical presentation,1ab and imaging examinations,therapeutic approaches and prognosis.Results:1.There were 19 male patients and 3 female patients with average age of 48.5±18.5.2.All patients had B-ultrasound and CT examination.Five cases were misdiagnosed by B-us,misdiagnosis rate was 28.8%;Four cases were misdiagnosed by CT,misdiagnosis rate was 18.2%.3.Of these 22 cases,the location of tumor were varied on all segments.The size of tumor was averagely 8×6.6×5.5cm³.All the tumor was well-capsuled.4.Majority of tumor were moderate-differentiated or welldifferentiated, of which 11 cases of well-differentiated.5.Follow-up was achieved on 20 cases with 0.5 to 5 years.Survival analysis showed 1,3,5 year survial rate were 91.2%,82.5%and 61.0% respectively with 60-month median survial time.Conclusion:1.Due to the low incidence and nonspecific presentation,diagnosis of EGHCC is hard to be established on early stage and preoperative stage.2.Surgical resection is the optimal therapeutic approach showing good outcome,contributed by the tumor biological characteristics,such as well-capsuled and good liver perservation.3.Improving the early-stage diagnosis and resectability remains to be the critical factor of achieving better survival rate.