• Vol. 39 No. 9, 734–737
  • 15 September 2010

Hepatocellular Carcinoma Peritoneal Metastases: Report of Three Cases and Collective Review of the Literature



Introduction: Patients with peritoneal metastases (PM) from hepatocellular carcinoma (HCC) often experience a rapid demise even after a complete removal of intrahepatic tumour. Localised PM may now be adequately controlled and managed with cytoreductive surgery (CRS).

Treatment: Three patients underwent CRS for HCC PM.

Outcome: The first patient survived 21 months from the time of CRS and is alive with the disease. The second patient died 4 months after CRS. The third patient survived 10 months since CRS and is also alive with the disease. Collectively, the survival of 24 patients with HCC PM extracted through a collective literature review who were treated with cytoreductive surgery had 1- and 2-year survival percentages of 83% and 71%, respectively.

Conclusion: Careful selection of patients with localised disease to the peritoneal cavity for CRS, taking into consideration the performance status, liver function and tumour biology may lead to a successful outcome in patients with HCC PM.

Peritoneal dissemination of hepatocellular carcinoma (HCC) is a rare presentation, with an incidence of 2% to 6% detected during autopsy or laparoscopy. Although uncommon, the morbid and fatal complications associated with peritoneal metastases, especially in patients with liver cirrhosis and coagulation deficiencies, deserve renewed attention given recent advances in the multi-modality management of peritoneal metastases.

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