Purpose: Hepatic resection has been considered as the standard treatment method for hepatocellular carcinoma, but the majority of patients have underlying liver cirrhosis that limits the extent of hepatic resection. However, the saftey and long-term results of major hepatic resection for the HCC patient with compensated cirrhosis has not yet been fully evaluated. So, we conducted this study to evaluate the perioperative outcomes and long-term survival following major hepatic resection for hepatocelluar carcinoma (HCC) in the patients with compensated cirrhosis.
Methods: We carried out retrospective analysis on the clinicopathological data of 132 HCC patients with histologically proven liver cirrhosis who underwent hepatic resection for HCC from Sep 1987 to Aug 2003. Among them, 49 HCC patients received major hepatic resection (group A). The perioperative outcomes and long-term survival of group A were compared with those of 83 patients who underwent minor hepatic resection (group B).
Results: Group A had significantly better liver function, a wider resection margin, a larger sized tumor, more frequent multiple lesions, and more total and minor complications than group B. However, the two groups showed similar results for the hospital stay, the perioperative blood transfusion and the major complication rate. The only prognostic factor for determining the occurrence of major complication was the transfusion. Both groups did not show statistical differences with regards to 5 year overall and disease free survival rate (67.8% vs 61%, 45.7% vs 35.5%, respectively).
Conclusion: Major hepatic resection for the hepatocellular carcinoma patient with compensated liver cirrhosis is an effective and safe treatment option with acceptable mortality and major complications rates. (J Korean Surg Soc 2006; 70:444-450)
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