Hepatic resection for hepatocellular carcinoma : an audit of 343 patients

• Published in: Annals of surgery 1995-03, Vol.221 (3), p.291-298
• Main Authors: LAI, E. C. S, SHEUNG-TAT FAN, CHUNG-MAU LO, KENT-MAN CHU, CHI-LEUNG LIU, WONG, J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Female; Gastroenterology. Liver. Pancreas. Abdomen; Hepatectomy; Humans; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Prognosis; Survival Rate; Treatment Outcome; Tumors
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-199503000-00012

The authors summarize the results of patients who had hepatectomy for hepatocellular carcinoma over a 22-year period. Recent reports showed improved perioperative results and long-term prognosis. The perioperative outcome of 343 patients was studied according to three different time periods: before 1987 (n = 149); 1987 to 1991 (n = 128); and 1992 to present (n = 66). Survival analysis was made by stratifying patients into two categories--either before or after 1987. The majority of patients had large tumors (78%), cirrhosis (73%), and a major hepatectomy (73%). Besides an increased resectability rate (23%), there was a marked reduction of the recent morbidity (32%; p < 0.001), operative (4.5%; NS) and hospital (6%; p < 0.02) mortality rates. The recent surgical approach was identified as a significant contributory factor to the lowered hospital mortality rate. Patients in the latter part of the study had significantly better survival, with a 1-, 3- and 5-year survival rate of 68%, 45%, and 35%, respectively. Early detection and effective treatment of recurrences contributed to the improved prognosis. The recent management strategy and technological advances improved the results of surgical treatment for patients with hepatocellular carcinoma.