Resection of hepatocellular carcinoma: a European experience on 328 cases.
OBJECTIVE
Surgical liver resection has been demonstrated in Asian countries to be the best therapeutic option in patients with hepatocellular carcinoma. Because the value of this treatment is still debated in Western countries, the aim of this paper was to report a European experience of resection for hepatocellular carcinoma.


METHODS
From 1990 to 1999, 239 men and 61 women aged from 15 to 77 years old underwent 328 resections including major resection in 138 (42%) cases. Normal liver was present in 53 patients (17%) and chronic liver disease was present in 247 including 152 (50%) with cirrhosis.


RESULTS
In-hospital mortality was 6.4% and was significantly influenced by the presence of chronic liver disease (1.7% vs. 7.4%). Mortality after resection in alcoholic patients (14%), in patients with hepatitis C (9%) was significantly higher than in patients chronic hepatitis B (1%) (P < 0.05). The overall survival rates were 81%, 57%, 37%, and 13% at 1, 3, 5 and 10 years. Five-year survival rate was significantly higher (P < 0.05) in patients with normal liver as compared to chronic liver disease (50% vs. 34%). In patients with chronic liver disease parameters, which significantly influenced survival rate, were vascular invasion, tumor differentiation and the extent of resection.


CONCLUSIONS
In this European study with varied profile of etiologies associated with hepatocellular carcinoma we showed that a five-year survival rate of 40% can be expected after resection and that chronic liver disease is a major factor influencing short and long-term prognosis.
Belghiti
J
J
Department of Hepatobiliary and Digestive Surgery, Beaujon Hospital, Paris VII University, Clichy, France. j.bel@bjn.ap-hop-paris.fr
Regimbeau
J M
JM
Durand
F
F
Kianmanesh
A R
AR
Dondero
F
F
Terris
B
B
Sauvanet
A
A
Farges
O
O
Degos
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D002908:Chronic Disease; D005060:Europe; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008107:Liver Diseases / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D017741:Survivors; D016896:Treatment Outcome