Prognostic factors after hepatectomy for hepatocellular carcinomas. A univariate and multivariate analysis.
The current study determines the prognostic factors after hepatectomy for hepatocellular carcinomas. The 295 patients who underwent hepatectomy from 1973 through 1987 were included for a univariate and a Cox multivariate analysis. The favoring conditions were determined as follows. The essential requirements are (1) the absence of tumor thrombi; (2) no intrahepatic metastasis, but even when present, it should be close to the main tumor and removed with a massive resection; and (3) retention rate of indocyanine green dye (ICG) at 15 minutes should be within 14 +/- 4.2% (M +/- SD) to allow that resection. The desired requirement is that the tumor size should preferably be less than 5 cm; a wider free margin from tumors (greater than or equal to 1 cm) is recommended, but not determining factor. The eligible patients, having no thrombi, no intrahepatic metastasis, a tumor size of 5 cm or less, negative surgical margin (greater than or equal to 1 cm), had achieved a 5-year survival of 78%. In conclusion, resection therapy is the first option for patients with those requirements.
Yamanaka
N
N
First Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Okamoto
E
E
Toyosaka
A
A
Mitunobu
M
M
Fujihara
S
S
Kato
T
T
Fujimoto
J
J
Oriyama
T
T
Furukawa
K
K
Kawamura
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis
D007208:Indocyanine Green