[The significance of extent of resection in the treatment of hepatoma].
The relationship between the types of hepatectomy in each stage of hepatoma and the outcome was examined in 222 patients with hepatoma, according to the rules established by Liver Cancer Study Group of Japan. In Stage 1, the survival rate after absolute curative resection was better than that after relative curative resection. In Stage II, the survival after segmentectomy or lobectomy was significantly better than that after subsegmentectomy or less. Tumor recurrence rates in the remaining liver after segmentectomy or lobectomy were significantly lower than that after smaller resections. In Stages III and IV, there was no difference in survival among the various extents of hepatectomy. Incidence and cause of death after hepatectomy were not influenced by the extent of hepatectomy, as far as it was not beyond the preoperatively estimated safety limits. These results indicate the following: 1) In Stage I, absolute curative resection must be carried out. (2) In Stage II, segmentectomy or lobectomy should be applied when feasible. (3) The patients treated with subsegmentectomy or less for Stage II tumor, and the patients with Stage III or Stage IV tumor are at high risk of recurrence, and those patients need adjuvant therapy after hepatectomy.
Nonami
T
T
Department of Surgery II, Nagoya University School of Medicine, Japan.
Kishimoto
W
W
Harada
A
A
Nakao
A
A
Takagi
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate