Hepatic resection for primary liver cancer at a private community hospital: retrospective study of 61 patients.
OBJECTIVE: To review the outcome after surgical resection for primary liver cancer. DESIGN: Retrospective study. SETTING: Private community hospital, Hong Kong. PATIENTS: Sixty-one consecutive patients who underwent liver resection for primary cancer from 1992 through 1997. MAIN OUTCOME MEASURES: Clinicopathological features, type of resection, duration of hospital stay, and actuarial overall and disease-free 5-year survival rates. RESULTS: Cirrhosis was present in 46 (75%) of the patients, and 42 (69%) were positive for hepatitis B surface antigen. The median tumour diameter was 8 cm (range, 1-16 cm). Liver resections consisted of hemihepatectomy (n=37), trisegmentectomy (n=4), segmentectomy (n=11), and wedge resection (n=9). Postoperative death and major morbidity occurred in 0% and 36% of patients, respectively; ascites was the most common complication. The median hospital stay was 11 days. The actuarial overall and disease-free 5-year survival rates were 36.0% and 22.8%, respectively. These results are similar to or better than those recently reported from local or overseas centres. Multivariate analysis showed that the Child-Pugh class significantly influenced the development of complications and the length of hospital stay, whereas a well-circumscribed tumour margin, the tumour-node-metastasis stage of the tumour, and the Child-Pugh class were independent predictors of survival. CONCLUSION: Surgical resection for primary liver cancer can be performed with acceptable safety and efficacy in a suitably staffed and equipped private community hospital.
Shiu
MH
The Hong Kong Sanatorium and Hospital, 2 Village Road, Happy Valley, Hong Kong.
Siu
DL
Hui
WM
Yu
HC
Lam
KC