Purpose: Our study aimed to investigate prognostic factors at presentation and the survival of patients with a resected hepatocellular carcinoma (HCC). Methods: A retrospective analysis of medical records was performed for 58 patients (59 cases)
identified through the Tumor Registry as having been evaluated for a hepatocellular carcinoma at the Chonbuk National University Hospital during the 10-year period from 1989 to 1999. Results: The male：female ratio was 3.2：1, and the average age
was
52.7 years. Liver cirrhosis and ascites were present in 64.4% and 8.5% of the patients, respectively, and 62.7% present with the HBs antigen. The positive alpha-fetoprotein (AFP) rate was 55.9% and the elevated alkaline phosphatase (ALP) rate was
32.2%.
The Child-Pugh's classifications of the patients were as follows: 49 cases (83.1%) of Grade A, 8 cases (13.6%) of Grade B, 2 cases (3.4%) of Grade C. The Indocyanine green (ICG) tests of normal range (＜10%) were 69.5%. The operative mortality
was
3.4%
(2 cases). Preopertive transarterial chemoembolization was performed in 23 cases (39.0%). The tumor was larger than 5 cm in 50.8% of the patients and was a single tumor in 72.9%. Portal vein invasion was present in 11.9% of the cases. The
surgical
procedure consisted of a curative resection in 43 cases (72.9%: lobectomy in 7, trisegmentectomy in 4, segmentectomy in 22, and wedge resection in 10) and a limited resection in 16 cases (27.1%). Of the patients, 44.1% had either TNM stage III or
stage
IV tumor. Recurrence of the tumor was diagnosed in 19 cases and was found in the residual liver in 13 cases (68.4%). Operative morbidity developed in 16 cases (27.1%) and hepatic failure, pleural effusion, ascites were common complications.
Conclusion:
A significantly higher survival rate was seen for HCC with no ascites and a normal ALP level. A curative resection was not superior to a limited resection in terms of survival. Recent management strategy and technical advances have improved the
results
of surgical treament for patients with a HCC.
|