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Tuesday, April 28, 2015
Liver Cancer Operation
Is there anyone that will still operate on a HCC liver with 12.4 Bilirubin and portal vain obstruction? Or give any other treatment at that (theraspheres, tace, avastin etc.?)
The answer to your question, sadly, is no. Anyone with a bilirubin as high as yours is at significant risk for liver failure and death if one proceeds with surgery. I do not know how much of your liver needs to be removed, however. In addition, portal vein thrombosis is another very serious risk for poor outcomes following liver surgery.
Unfortunately, with a Bilirubin that high, just about anything we can do to your liver may very seriously affect its function and hence your survival. No one I know of would perform theraspheres or tace. There is little role or avastin in HCC. Depending upon how large your tumor is, and where it is located, someone may be aggressive enough to ablate the tumor. This would still be risky, but much less so than doing a resection (removing a piece of the liver). I hope this helps and best wishes.
Steven M Rudich, MD, PhD, FACS
Professor of Surgery, Director of Liver Transplat and Hepatobiliary Surgery
College of Medicine
University of Cincinnati