Trends in surgical results of hepatic resection for hepatocellular carcinoma: 1,000 consecutive cases over 20 years in a single institution

• Published in: The American journal of surgery 2014-06, Vol.207 (6), p.890-896
• Main Authors: Yamashita, Yo-ichi, M.D., Ph.D, Tsuijita, Eiji, M.D., Ph.D, Takeishi, Kazuki, M.D, Ishida, Teruyoshi, M.D., Ph.D, Ikegami, Toru, M.D., Ph.D, Ezaki, Takuhiro, M.D., Ph.D, Maeda, Takashi, M.D., Ph.D, Utsunomiya, Tohru, M.D., Ph.D, Nagasue, Naofumi, M.D., Ph.D, Shirabe, Ken, M.D., Ph.D, Maehara, Yoshihiko, M.D., Ph.D
• Format: Article
• Language: English
• Subjects: 5-year disease-free survival; 5-year survival; Aged; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Female; Hepatectomy - mortality; Hepatectomy - trends; Hepatic resection; Hepatitis; Hepatocellular carcinoma; Hospital Mortality - trends; Hospitals; Humans; Liver cancer; Liver cirrhosis; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Male; Medical prognosis; Middle Aged; Morbidity; Morbidity and mortality; Mortality; Neoplasm Recurrence, Local; Prognosis; Retention; Risk Factors; Surgery; Surgical outcomes; Surgical techniques; Survival Rate; Time Factors; Treatment Outcome; Trends
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2013.07.028

Abstract Background Surgical results have been reported to be improved in hepatic resections for hepatocellular carcinoma (HCC) in recent years, but the detailed trends in surgical results for HCC in a single high-volume center are still not clear. Methods Surgical results in 1,000 hepatic resections for HCC performed at a single medical center from 1989 to 2011 were analyzed. Patients were divided into 3 groups: those performed in the early period (1989 to 1995, n = 181), the middle period (1996 to 2004, n = 391), and the late period (2005 to 2011, n = 428). Results Hospital mortality (3.9%, 1.0%, and .5%; P = .0027) and morbidity (45%, 24%, and 15%; P < .0001) rates were significantly decreased. The overall survival rates were significantly improved (50%, 72%, and 78% at 5 years; P = .0021), but there was no significant difference in the disease-free survival (29%, 34%, and 31% at 5 years; P = .7823). Conclusions Surgical results of hepatic resections for HCC were significantly improved, with the mortality rate nearly reaching 0%. The 5-year survival rate after hepatic resections for HCC was also improved to 78%, but the consistently high rate of HCC recurrence after hepatic remains a problem.