Clinical Study of Factors for Estimating the Prognosis after a Resection of a Hepatocellular Carcinoma.
- Author:
Hyun Jo YOUN
1
;
Hee Chul YU
;
Baik Hwan CHO
Author Information
1. Department of Surgery, School of Medicine, Chonbuk National University, Chonju, Korea.
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma;
Hepatic resection;
Prognostic factor
- MeSH:
Alkaline Phosphatase;
alpha-Fetoproteins;
Ascites;
Carcinoma, Hepatocellular*;
Classification;
Humans;
Indocyanine Green;
Jeollabuk-do;
Liver;
Liver Cirrhosis;
Liver Failure;
Mastectomy, Segmental;
Medical Records;
Mortality;
Pleural Effusion;
Portal Vein;
Prognosis*;
Recurrence;
Reference Values;
Retrospective Studies;
Survival Rate
- From:Journal of the Korean Surgical Society
2000;59(5):633-642
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Our study aimed to investigate prognostic factors at presentation and the survival of patients with a resected hepatocellular carcinoma (HCC). METHODS: A retrospective analysis of medical records was performed for 58 patients (59 cases) identified through the Tumor Registry as having been evaluated for a hepatocellular carcinoma at the Chonbuk National University Hospital during the 10-year period from 1989 to 1999. RESULTS: The male:female ratio was 3.2:1, and the average age was 52.7 years. Liver cirrhosis and ascites were present in 64.4% and 8.5% of the patients, respectively, and 62.7% present with the HBs antigen. The positive alpha-fetoprotein (AFP) rate was 55.9% and the elevated alkaline phosphatase (ALP) rate was 32.2%. The Child-Pugh's classifications of the patients were as follows: 49 cases (83.1%) of Grade A, 8 cases (13.6%) of Grade B, 2 cases (3.4%) of Grade C. The Indocyanine green (ICG) tests of normal range (<10%) were 69.5%. The operative mortality was 3.4% (2 cases). Preopertive transarterial chemoembolization was performed in 23 cases (39.0%). The tumor was larger than 5 cm in 50.8% of the patients and was a single tumor in 72.9%. Portal vein invasion was present in 11.9% of the cases. The surgical procedure consisted of a curative resection in 43 cases (72.9%: lobectomy in 7, trisegmentectomy in 4, segmentectomy in 22, and wedge resection in 10) and a limited resection in 16 cases (27.1%). Of the patients, 44.1% had either TNM stage III or stage IV tumor. Recurrence of the tumor was diagnosed in 19 cases and was found in the residual liver in 13 cases (68.4%). Operative morbidity developed in 16 cases (27.1%) and hepatic failure, pleural effusion, ascites were common complications. CONCLUSION: A significantly higher survival rate was seen for HCC with no ascites and a normal ALP level. A curative resection was not superior to a limited resection in terms of survival. Recent management strategy and technical advances have improved the results of surgical treament for patients with a HCC.
