Background/aims: The effectiveness of multimodal therapy for Stage IVa hepatocellular carcinoma was investigated.
Material and methods: Between 1982 and 1994, 40 patients with primary Stage IVa tumors were treated in our clinical unit.
Results: The overall survival rate was 79.7% at 1 year, 37.0% at 3 years, and 20.8% at 5 years. However, the most successful multimodal therapy, a combination of hepatectomy, embolization, and ethanol injection, achieved significantly better results (92.9% at 1 year, 59.6% at 3 years, and 47.7% at 5 years). This improved survival could still be obtained by multimodal therapy, even when surgical resection was incomplete.
Conclusion: These results suggest that multimodal therapy including hepatectomy can be recommended for improving the survival of patients with Stage IVa hepatocellular carcinoma.