title: A 15-year retrospective study of hepatic resection for stage IV-A hepatocellular carcinoma shows value in hepatitis B negative patients.
abstract: BACKGROUND
  The aim of this study is to identify the risk factors of survival and recurrence after curative hepatic resection for stage IV-A hepatocellular carcinoma (HCC).
  
  
  METHODS
  Sixty-five patients with stage IV-A HCC who underwent curative hepatic resection and discharged from hospital were enrolled in this retrospective study. Prognostic factors were evaluated by univariate and multivariate analysis. Clinicopathologic features and survival with stage IV-A HCC were compared with those of 290 patients with stage I to III HCC who underwent curative hepatic resection during the same period.
  
  
  RESULTS
  Disease-free and overall survival for patients with stage IV-A HCC was significantly lower than for those with stage I to III HCC. Positive hepatitis B virus (HBV) surface antigen was an independent prognostic factor of poor disease-free and overall survivals in patients with stage IV-A HCC. There were no significant differences in the disease-free and overall survivals between non-HBV-related stage IV-A HCC and stage I to III HCC.
  
  
  CONCLUSIONS
  Even for patients with highly advanced HCC, curative hepatic resection may be a feasible therapeutic option for those with non-HBV-related HCC.
authors.affiliation: Second Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 Japan. hanayan@hsp.md.shinshu-u.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
authors.forename: Shoji
authors.initials: S
authors.lastname: Kajikawa
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Shimozawa
authors.forename: Motohiro
authors.initials: M
authors.lastname: Mihara
authors.forename: Ko
authors.initials: K
authors.lastname: Shimada
authors.forename: Manabu
authors.initials: M
authors.lastname: Hiraguri
authors.forename: Naohiko
authors.initials: N
authors.lastname: Koide
authors.forename: Wataru
authors.initials: W
authors.lastname: Adachi
authors.forename: Jun
authors.initials: J
authors.lastname: Amano
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery* / Q000821:virology; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome