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Original ArticleOpen Access
Gigantic Hepatocellular Carcinoma, Treated by Transcatheter Oily Chemoembolization (TOCE) and Wedge Hepatic Resection
Eurvilaichit C 
,
Kanjanapitak A ,
Leopairut J
,
Kanjanapitak A ,
Leopairut J CHARINDR EURVILAICHIT, B.Sc., M.D.*,
AUCHAI KANJANAPIT AK, M.D.**,
JUVADY LEOPAIRUT, B.Sc., M.D.***
Four cases of gigantic hepatocellular carcinoma, considered by surgeons to be inoperable,
were treated with repeated transcatheter chemoembolization (TOCE) until the serum alfafeto-
protein reduced to normal or less than half of the original level or until the tumor reduced to less
than half of the original size documented by CT scan and angiogram. Wedge hepatic resection
was performed using ultrasonic dissector. Histologic section of the resected tumor mass revealed
tumor necrosis. The extent of tumor necrosis was related to tumor size and corresponded inversely
to the thickness of the tumor capsule. The survival periods were 48 to I 08 months with only one
to two episodes of recurrence during follow-up. Repeated wedge hepatic resection was
performed successfully for recurrent cases.
Serum alfafetoprotein (AFP) is a very sensitive and reliable tumor marker for follow-up
results and appears to be a sensitive indicator for tumor recurrence.
Key word : Gigantic Hepatocellular Carcinoma, Treatment
AUCHAI KANJANAPIT AK, M.D.**,
JUVADY LEOPAIRUT, B.Sc., M.D.***
Four cases of gigantic hepatocellular carcinoma, considered by surgeons to be inoperable,
were treated with repeated transcatheter chemoembolization (TOCE) until the serum alfafeto-
protein reduced to normal or less than half of the original level or until the tumor reduced to less
than half of the original size documented by CT scan and angiogram. Wedge hepatic resection
was performed using ultrasonic dissector. Histologic section of the resected tumor mass revealed
tumor necrosis. The extent of tumor necrosis was related to tumor size and corresponded inversely
to the thickness of the tumor capsule. The survival periods were 48 to I 08 months with only one
to two episodes of recurrence during follow-up. Repeated wedge hepatic resection was
performed successfully for recurrent cases.
Serum alfafetoprotein (AFP) is a very sensitive and reliable tumor marker for follow-up
results and appears to be a sensitive indicator for tumor recurrence.
Key word : Gigantic Hepatocellular Carcinoma, Treatment
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