[Three-grade criteria of curative resection for primary liver cancer].
OBJECTIVE
To clarify three-grade criteria of curative resection for primary liver cancer (PLC) and evaluate their clinical significance.


METHODS
Criteria of curative resection of PLC were summed up to three grades. Grade I: complete removal of all gross tumors with no residual tumor at the excision margin. Grade II: on the basis of Grade I, there was no extrahepatic metastasis, no hilar lymph node metastasis, no tumor thrombus in the main trunks and their primary tributaries of the portal vein, common hepatic duct, hepatic vein and vena cava inferior, and the tumor was not more than two in number. Grade III: in addition to the above criteria, AFP dropped to normal level (in patients with elevated AFP before surgery) within 2 months after operation, and no residual tumor upon diagnostic imaging. A total of 354 cases with PLC who had their liver resected was reviewed. Patients in each grade were divided into two portions depending on whether the treatment was curative or palliative.


RESULTS
The survival of patients receiving curative treatment was better than those receiving palliative treatment (P < 0.01). This was true for patients whose treatment belonged to anyone of the three-grade criteria. The survival was improved along with the promotion of curative criteria used. The 5-year survival rate of Grade I, II and III patients undergone curative resection was 43.2%, 51.2% and 64.4%, respectively (P < 0.01).


CONCLUSIONS
1. The three-grade criteria may be used for judging the radicality of tumor resection for PLC. 2. The more stringent the criteria used, the better the survival would be. 3. Adopting high-grade criteria to select cases, to guide operation and postoperative follow-up would improve the results of liver resection for PLC.
Ma
Zeng-chen
ZC
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Huang
Li-wen
LW
Tang
Zhao-you
ZY
Zhou
Xin-da
XD
Lin
Zhi-ying
ZY
Qin
Lun-xiu
LX
Ye
Qing-hai
QH
Sun
Hui-chuan
HC
Ren
Zheng-gang
ZG
Xia
Jing-lin
JL
D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate