Clinical Outcome of 457 Hepatic Resection Cases for the Treatment of Hepatocellular Carcinoma

Yim, Jin Ho; Kim, Sang Bum; Cho, Eung Ho; Choi, Dong Wook

Abstract

BACKGROUND
& PURPOSE: This purpose of this study was to determine the prognostic factors for hepatocellular carcinoma (HCC) in patients who received curative hepatectomies at our institution. PATIENT AND METHOD: A retrospective analysis was performed on 457 patients who had undergone hepatectomies between Mar 1987 and Feb 2008 for HCC at the Korea Cancer Center Hospital, Seoul, Korea. The number of males enrolled in the study was 366 and the number of females enrolled was 91. The mean age of the patients was 52.8 years old. Hepatitis B virus-related disease was the most frequent etiology (335/457 patients). Two hundred nine (209) patients had liver cirrhosis, and 93.9% of patients were classified in Child-Pugh Class A. RESULT: The complication rate was 30.6% (140/457) and the operative mortality was 1.5% (7/457). Reoperation was performed in 7 complicated patients. Five-and 10-year overall survival rates of the patients were 57.7% and 41.8% respectively. Poor prognostic factors of overall survival were Child B class, Edmonson-Steiner histologic grade 3 or 4, tumor vascular invasion, and postoperative complications. Five-and 10-year disease-free survival rates were 42.7% and 32.5%, respectively. Poor prognostic factors for disease free survival included the following an Edmonson-Steiner histologic grade of 3 or 4, tumor vascular invasion, and postoperative complications.
CONCLUSION
Postoperative complication is independently a poor prognostic factor for overall and disease free survival in our study. We suggest that special care is needed while performing hepatic resections for the treatment of HCC in order to reduce postoperative complications.