Major compared with limited hepatic resection for hepatocellular carcinoma without underlying cirrhosis: a retrospective analysis.
OBJECTIVE
To find out if patients with hepatocellular carcinoma (HCC) with no underlying cirrhosis benefit from major hepatic resection.


METHODS
Retrospective study.


METHODS
University hospital, Japan.


METHODS
58 patients without cirrhosis and with HCC 10 cm in diameter or less.


METHODS
25 had major and 33 had limited hepatic resections.


METHODS
Overall and disease-free survival, and prognostic factors verified by univariate and multivariate analyses.


RESULTS
6 patients developed major complications (10%), two of whom died within 60 days of operation. There were no differences in postoperative morbidity and mortality between the two groups. The overall and disease-free survival were similar as was the incidence and pattern of intrahepatic tumour recurrence. Hepatitis B surface (HBs) antigen (positive), tumour size (smaller than 3 cm), and surgical margin (clear) were favourable indicators of disease-free survival on multivariate analysis.


CONCLUSIONS
Major hepatic resection should not necessarily be done for HCC without cirrhosis but it is important to take an adequate surgical margin. Overall and disease-free survival are better in patients who are HBs-antigen positive than those who are negative because most of the latter are positive for hepatitis C virus.
Nagasue
N
N
Department of Surgery, Shimane Medical University, Izumo, Japan.
Yamanoi
A
A
el-Assal
O N
ON
Ohmori
H
H
Tachibana
M
M
Kimoto
T
T
Kohno
H
H
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis; D008111:Liver Function Tests / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies