Single Center Experience (Ten Years) with Surgical Resection for Treating Hepatocellular Carcinoma: Strategies for improving the long-term survival after resection.
- Author:
Dai Hoon HAN
1
;
Gi Hong CHOI
;
Dong Hyun KIM
;
Sae Byeol CHOI
;
Chang Moo KANG
;
Kyung Sik KIM
;
Jin Sub CHOI
;
Young Nyun PARK
;
Jun Yong PARK
;
Do Yong KIM
;
Kwang Hyub HAN
;
Chae Yoon CHON
;
Woo Jung LEE
Author Information
1. Department of Surgery, Yonsei University Health System, Seoul, Korea. Choi5491@yuhs.ac
- Publication Type:Original Article
- Keywords:
hepatocellular carcinoma;
curative resection;
long-term outcome
- MeSH:
Alkaline Phosphatase;
Aspartate Aminotransferases;
Carcinoma, Hepatocellular;
Disease-Free Survival;
Early Diagnosis;
Fibrosis;
Humans;
Liver Cirrhosis;
Multivariate Analysis;
Patient Selection;
Platelet Count;
Postoperative Complications;
Recurrence;
Retrospective Studies;
Serum Albumin;
Survival Rate;
Transplants
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2008;12(4):245-253
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Although surgical resection is the most effective treatment for hepatocellular carcinoma (HCC), high recurrence after resection is a major challenging problem. We attempted to determine the optimal strategies for improving the long-term surgical outcome through the review of our 10 years' experience with surgically treating HCC. METHODS: We retrospectively reviewed 497 patients who received curative resection at the Yonsei University Health System from January 1996 to August 2006. RESULTS: The 5 year disease-free rate and the overall survival rate after curative resection were 45.0% and 63.9%, respectively. Of the 497 patients, 491 (98.8%) were Child-Pugh A and 107 (56.3%) were diagnosed with liver cirrhosis. The postoperative complication and mortality rates were 28.6% and 1.8%, respectively. Of the 243 recurrent patients, 184 (75.7%) were diagnosed with intrahepatic recurrence alone. Of these intrahepatic recurrent patients, 169 (91.9%) received active treatment, including transplantation (n=7), re-resection (n=12), local ablation therapy (n=18) and transarterial chemoembolization (n=132). Multivariate analysis revealed that perioperative transfusion, a satellite nodule, the pathologic TNM stage, the Edmondsons-Steiner grade, the serum alkaline phosphatase (ALP) and aspartate aminotransferase levels and cirrhosis were associated with disease free survival, and perioperative transfusion, a satellite nodule, macroscopic vascular invasion, the Edmondsons-Steiner grade, the ALP and serum albumin levels and the platelet count were related with overall survival after resection. CONCLUSIONS: The long-term surgical outcome of HCC can be further improved by proper patient selection, delicately performed surgery and administering postoperative adjuvant therapy for patients with a high risk of recurrence. Early diagnosis and aggressive treatment are needed to treat the recurrence
