Long-term results and prognostic factors after anatomical hepatectomy for hepatocellular carcinoma: a report of 90 patients
10.3760/cma.j.issn.1007 8118.2012.02.009
- VernacularTitle:解剖性肝切除治疗肝细胞癌的长期结果和预后影响因素分析:附90例报告
- Author:
Huanwei CHEN
;
Shan LIAO
;
Fengjie WANG
;
Meisheng LI
;
Zuojun ZHEN
- Publication Type:Journal Article
- Keywords:
Hepatocellular carcinoma;
Anatomical hepatectomy;
Prognostic factor
- From:
Chinese Journal of Hepatobiliary Surgery
2012;18(2):110-114
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and long-term therapeutic results of anatomical hepatectomy for hepatocellular carcinoma (HCC).Methods 90 patients underwent anatomical hepatectomy from January,2003 to January,2010.The tumor size was ≤5 cm in 38 patients,and ＞5 cm in 52 patients.The tumor number was a single lesion in 58 patients,and multiple lesions in 32 patients.Cirrhosis was present in 46 patients (55.42％); cancer embolus was present in 34 patients (37.78％).There were 64 patients in Child-Pugh A and 26 patients in B.The operating time,blood loss and blood transfusion were recorded and analyzed.Complications and liver function were monitored after surgery.The Kaplan-Meier method was used to calculate the survival rates.Log-rank test was used to analyze factors associating with postoperative recurrence.Independent factors influencing tumor-free survival and overall survival were analyzed by Cox-model logistic regression.Result There was no perioperative death.The incidence of complications was 31.1％ (28/90).The recurrence rate was 51.1％ (46/90).The 1-,3-,5 year tumor-free survivals were 92.2％,67.3％ and 49.7％％00,respectively.Positive resection margin and satellite nodule were independent factors for recurrence (RR19.22,95 ％ confidence interval 5.85～63.17).The 1-,3-,5-year overall survivals were 94.4％,80.0％ and 60.0％,respectively.Positive resection margin and TNM were independent factors for overall survival (RR 2.013,95％ confidence interval 1.28～3.17).Conclusions Anatomical hepatectomy was a safe and efficacious procedure to treat HCC.Positive resection margin and TNM were independent factors associated with overall survival.Anatomical hepatectomy had the advantages in ensuring a lower rate of negative resection margin.
