title: Results of hepatic resection for hepatocellular carcinoma.
abstract: The results of 122 hepatic resections in 112 patients with hepatocellular carcinoma are described. The type of liver resection performed was selected according to the patient's liver function. Forty-nine patients underwent anatomic resections, including 1 trisegmentectomy, 5 lobectomies, 11 segmentectomies, and 32 subsegmentectomies; the remaining 63 patients had nonanatomic resections. The 1-, 2-, and 3-year survivals after liver resection for all patients, taking into account one operative and one hospital death (0.9% each), were 92.4%, 85.0%, and 78.9%, and disease-free survivals at 1, 2, and 3 years were 68.6%, 46.2%, and 32.6%, respectively. Twenty-one repeat hepatic resections (17.2% of the total of 122 resections) were performed with no hospital mortality. Cumulative survival from the time of repeat hepatectomy in these 21 patients was 84.2% and 56.3% at 1 and 2 years, respectively. Among the factors that may affect survival or disease-free survival, the absence of vascular invasion (p < 0.05) and intrahepatic metastases (p < 0.01) were significantly related to the disease-free survival time. A good outcome was obtained after liver resection in 112 patients with hepatocellular carcinoma through appropriate choice of the type of resection, careful follow-up, and a vigorous surgical approach for recurrence.
authors.affiliation: First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kawasaki
authors.forename: M
authors.initials: M
authors.lastname: Makuuchi
authors.forename: S
authors.initials: S
authors.lastname: Miyagawa
authors.forename: T
authors.initials: T
authors.lastname: Kakazu
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Kasai
authors.forename: S
authors.initials: S
authors.lastname: Miwa
authors.forename: A M
authors.initials: AM
authors.lastname: Hui
authors.forename: K
authors.initials: K
authors.lastname: Nishimaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012086:Reoperation