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KMID : 0614619930250010129
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Korean Journal of Gastroenterology
1993 Volume.25 No. 1 p.129 ~ p.139
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Prognostic Factors in Hepatocellular Carcinoma after Hepatic Resection in 279 Patients
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Abstract
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To further define the clinicopathologic features and determinants of survival we reviewed the cases of 279 patients with primary hepatic malighancy managed surgically between 1981 and 1990.
There were 279 patients who had hepatic resection due to primary hepatocellular carcinoma. Male to female ratio was 5.8 to 1 and their average age was 53 years. Ten variables were subject to univariate analysis and their survivals were calculated
using
the method of life table. 79.1% of patients had chronic hepatic disease inciuding liver cirrhosis and chronic active hepatitis and 124 patients (74.2%) were positve in HBsAg. Alpah-fetoprotein was high in 67% (normal 20ng/ml). Curative resection
was
done in 194 patients. Operative mortality was 11.4%, operative mortality was significantly associated with preoperative liver function and intraoperative blood loss. Median survival was 33 months, with 5 year survival of 28.3%. univariate
analysis
showed that Child's classification. Encapsulation, number of tumor, size of tumor and eperative procedure were associated with 5 year survival rate (p<0.05) and liver cirrhosis, slpha-fetoprotein. HBsAg. Preoperative transcatheter hepatic
arterial
embolization (TAE) and resection margin were not related with 5 year survival rate (p>0.05). there was no difference in survival rate between limited hepatic resection and major hepatic resection in 93 patients of small HCC (tumor size less than
5
cm).
There was significant difference in survival rate in limited hepatic resection and major hepatic resection in liver cirrhotic-patients (n=140).
So we conclude that early detection with tumor marker and sonography in high risk patients and curative resection are the best way to improve the long term result in HCC. And preoperative evaluation of liver fuction and decrease intraoperative
blood
loss are the best way to decrease operative mortality. In small HCC with liver cirrhosis, we think that limited hepatic resection is an effective treatment.
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