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Incidence and clinical outcome of icteric type hepatocellular carcinoma.

Abstract：

BACKGROUND:To elucidate the incidence of the rare cases of icteric type hepatocellular carcinoma (IHCC), we conducted a retrospective study. The clinical outcomes of IHCC cases were also analyzed. METHODS:From January 1986 to December 1997, newly diagnosed HCC cases were evaluated and reviewed from an admission registration database in a medical center. Patients who had HCC tumors which were located within biliary tracts, and caused obstructive jaundice as the initial clinical manifestation of HCC, were defined as cases of IHCC. Besides clinical manifestations, the outcomes and survival times of various treatment strategies among the IHCC cases were compared retrospectively. RESULTS:The incidence of IHCC was 0.53% (10/1897). The median age of the 10 IHCC patients (seven men, three women) was 56.1 years (range = 41-72 years). Most primary HCC lesions (80%) were of expansive type: either single nodular type or multinodular type. All the patients eventually died of cholangitis and sepsis. Besides biliary drainage, seven patients of moderate to good liver reserve function received transarterial chemoembolization (TACE) for palliative treatment, and three of these received additional radiotherapy (R/T) because of the limited effect of TACE (total dosage ranged from 1600 to 5000 cGy). One patient received only radiotherapy (total dosage 1600 cGy) because of having a single tumor and poor liver reserve function. The median survival time among those eight patients who received palliative treatment was 13.4 months (range = 8-26 months), which was significantly longer than for the other two patients without treatment (2 and 4 months). CONCLUSIONS:Icteric type hepatocellular carcinoma (IHCC) is a rare presentation of HCC. Palliative treatment strategies, including TACE and/or R/T showed a beneficial effect in improving the survival time.

journal_name

J Gastroenterol Hepatol

journal_title

Journal of gastroenterology and hepatology

authors

Huang JF,Wang LY,Lin ZY,Chen SC,Hsieh MY,Chuang WL,Yu MY,Lu SN,Wang JH,Yeung KW,Chang WY

doi

10.1046/j.1440-1746.2002.02677.x

subject

Has Abstract

pub_date

2002-02-01 00:00:00

pages

190-5

issue

eissn

0815-9319

issn

1440-1746

pii

2677

journal_volume

pub_type

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Incidence and clinical outcome of icteric type hepatocellular carcinoma.