Prognostic Factor Analysis of 200 Consecutive Hepatic Resections for Hepatocellular Carcinoma.
- Author:
Hyung Il SEO
1
;
Sang Jae PARK
;
Seong Hoon KIM
;
Woo Jin LEE
;
Min AHN
;
Hong Suk PARK
;
Yung Il KIM
;
Jung A SHIN
;
Kyung Woo PARK
;
Soon Ae LEE
;
Eun Kyung HONG
;
Joong Won PARK
;
Chang Min KIM
Author Information
1. Center for Liver Cancer, National Cancer Center, Goyang, Korea. spark@ncc.re.kr
- Publication Type:Original Article
- Keywords:
Carcinoma, Hepatocellular;
Hepatocellular Hepatectomy;
Prognostic Factor
- MeSH:
alpha-Fetoproteins;
Aspartate Aminotransferases;
Biomarkers;
Carcinoma, Hepatocellular*;
Classification;
Disease-Free Survival;
Factor Analysis, Statistical*;
Follow-Up Studies;
Hepatectomy;
Hospital Mortality;
Humans;
Liver;
Multivariate Analysis;
Recurrence;
Retrospective Studies;
Risk Factors
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2006;10(1):21-28
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The long-term outcome after liver resection for hepatocellular carcinoma (HCC) is somewhat disappointing because of tumor recurrence. The purposes of this study were to evaluate the prognostic factors and to suggest the data to improve the long-term outcome of hepatic resection for HCC. METHODS: A retrospective survey was carried out in 200 patients undergoing hepatic resection for HCC from April 2001 to June 2004. The various clinicopathologic factors were analysed for the overall survival (OS) and the disease-free survival (DFS) rates by the univariate test (log rank test) and multivariate test (Cox regression model). RESULTS: There were one hospital mortality and 23% morbidity after partial hepatectomy. Intraoperative transfusion was given to 20 patients (10%). Mean follow-up period was 19 months (range, 2-43). The 1-, 2- and 3-year OS rates after hepatic resection for HCC were 90.5%, 86.8% and 76.2% and the 1-, 2- and 3-year DFS rates were 65.5%, 54.3% and 49.4%, respectively. By the univariate analysis for OS, aspartate aminotransferase (AST), Child-Pugh classification, Edmondson-Steiner histologic grade, microvascular invasion, major vessel invasion, alpha-fetoprotein (AFP), TNM stage, transfusion, surgical margin involvement and presence of complication were significant for survival. By the multivariate analysis, Child-Pugh classification, Edmondson-Steiner histologic grade, major vessel invasion and complication were independent risk factors for OS. Whereas viral marker, Child-Pugh classification, microvascular invasion, major vessel invasion, AFP, TNM stage, surgical margin involvement and presence of complication were the significant risk factors for DFS by the univariate analysis, viral marker, microvascular invasion, major vessel invasion, surgical margin involvement and presence of complication were the independent predictive factors of the DFS. CONCLUSION: Hepatic resection for HCC has become safe. To improve the long-term outcome of hepatic resection for HCC, the patients with poor liver function or major vessel invasion should be precluded in hepatic resection, if possible, and adequate surgical margin and avoidance of complication are mandatory.
