A team from Rotterdam, the Netherlands, evaluated the indications and long-term outcome of treatment for benign hepatic tumors.
A total of 208 patients diagnosed as having a benign liver tumor between 1979 and 1999 were enrolled in the retrospective study.
Of these, 74 patients underwent hepatic surgery and 134 were managed conservatively by radiological follow-up.
Symptoms and complications were assessed during management and follow-up.
In the surgically treated population, the liver lesion was symptomatic in 47 patients (64%) and an incidental finding in 27 (36%).
The operative morbidity and mortality were 27% (20/74 patients) and 3% (2/74 patients), respectively.
| Patients asymptomatic after treatment:|
Conservative management 87%
|Archives of Surgery|
Overall, 28 (80%) of 35 patients with complaints were asymptomatic after surgery.
During observation of the tumor in the conservatively managed group, 39 (87%) of 45 patients who presented with complaints were asymptomatic during a mean follow-up of 45 months. Some 6 patients had mild abdominal pain considered to be unrelated to the tumor.
Dr Türkan Terkivatan, of the Department of Surgery, University Hospital Rotterdam, said on behalf of fellow authors, "Conservative management of solid benign liver lesions, such as focal nodular hyperplasia and hemangioma, can be performed safely, irrespective of their size.
"We only advise surgery for liver lesions when there is an inability to exclude malignancy, or in the case of severe complaints related to the tumor."
"Resection is always advocated in the case of a large hepatocellular adenoma (greater than 5 cm) to reduce the risk of rupture and malignant degeneration," it was concluded.