Narrow Results

The relationship of liver regeneration to immunoactivity was examined after ursodesoxycholic acid (UDCA) administration to partially (about 66%) hepatectomized rats. The UDCA was given orally. Liver regeneration was evaluated by the hepatocyte mitotic index (MI) and immunoactivity by natural killer cell (NK) activity in the blood. When UDCA 12.5 mg/kg/day was administered, a significant increase in the MI was observed 2 and 3 days after hepatectomy, and the MI response 2 days after hepatectomy tended to be dose-dependent in the range of 0–25 mg/kg/day. NK activity was decreased 2 days after hepatectomy when UDCA was given, and a significant correlation between MI and NK activity was obtained. The increase in MI and decrease in NK activity was blocked completely or partially (respectively) by interleukin-2 administration. It was also noted that UDCA did not affect serum parameters indicating liver and kidney function.

These findings suggest that liver regeneration can be modified by orally administered UDCA through a change in immunoactivity.

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, particularly in Asia. Surgical resection may be the treatment likely to result in long-term survival. The indications for surgical resection are limited, however, to patients with satisfactory functional liver reserve. Liver transplantation can provide longer disease-free survival rates in HCC patients irrespective of live function if selected based on the size and number of tumors. The usefulness of chemotherapy and local ablative treatment for HCC prior to transplantation remains unclear. Cadaveric graft shortage remains a problem and optimal management during the waiting time must be determined. Living donor liver transplantation and domino transplantation remain alternative therapeutic modalities for HCC.

Hepatocellular carcinoma (HCC) is one of the most aggressive abdominal tumors and has a poor prognosis if left untreated. Surgical resection for HCC remains the only potential for cure. Advances in tumor imaging, surgical technique and perioperative care have paved the way for better outcomes following surgical resection of HCC. Mortality rates of less than 5% and long-term survival are achievable by most specialized hepatobiliary units. Moreover, surgeons have now expanded the indications of surgery for HCC to include lesions once considered "irresectable." In this review, we focus on the current status in preoperative selection and optimization of patients, advances in surgical technique as well as the expanding indications of surgery for HCC.