In the 1950s, hepatic lobectomy for huge hepatocellular carcinoma (HCC) has benfited 5-10% of HCC patients; in the 1970s, limited resection for small HCC and reresection for recurrence have benefited another 5-10% HCC patients. Cytoreduction and sequential resection for unresectable HCC might be of benefit to a further 5-10% HCC patients in the 1990s. Analysis of 1,642 patients with pathologically proven HCC in 1959-1991 demonstrated that the series 5-year survival has increased from 3.0%(n=136) in the 1960s, to 12.2% (n=440) in the 1970s, to 40.2% (n=1,066) in the 1980s, which was correlated to the increasing number of limited resections for small HCC, re-resections for subclinical recurrence, and cytoreductions and sequen-tial resections for portions of unresectable HCC. With the advances in early detection, multimodality treatment, and changing concepts in early detection, multimodality treatment, and changing concepts in surgical oncology, the role of surgery in the treatment of HCC has increased.

To understand the genetic mechanisms underlying the progression of hepatocellular carcinoma(HCC) metastasis, differences of genomic alter-ations between 10 pairs of primary HCC tumors and their matched metastatic lesions were analyzed by comparative genomic hybridization. Several chromosomal alterations including loss of 8p, 4q, 17p, and 19p, gain of 5p and high-level amplification of lq12-q22 were detected in two or more cases. The most significant finding is the loss of 8p which was detected in 8 metastatic tumors but only in 3 corresponding primary tumors(P=0.03). This result suggests that the deletion of chromosome 8p might contribute to the development of HCC metastasis. Another inter-esting result is the detection of a minimum high-lever amplification region at lq12-q22 in HCC. This result provides a candidate amplification region at lq12-q22 in HCC. This result provies a candidate amplification region in HCC for further study to identify amplified oncogenes related to the development or progression of HCC. Finally, this study provides a prac-ticable model to detect specific genetic alterations related to the tumormetastasis through comparing the primary tumor and its corresponding metastatic lesion using comparative genomic hybridization technique.