Favorable surgical outcomes in patients with early hepatocellular carcinoma.
BACKGROUND
Early hepatocellular carcinoma (HCC) is defined as well-differentiated HCC with an obscure tumor margin in the classification of the Liver Cancer Study Group of Japan. However, the surgical outcomes in patients with early HCC have not yet been clarified.


METHODS
From 1985 to 1994, 186 patients with HCC 2 cm or less in greatest dimension underwent curative hepatectomy. Of the 186 cases, 37 were early HCC and 149 were small advanced HCC. The relationship between clinicopathological findings and surgical outcomes was examined.


RESULTS
The rate of hepatitis C antibody or number of tumors was significantly higher in patients with early HCC than in patients with small advanced HCC. Liver function test showed no differences between patients with early HCC and patients with small advanced HCC. The 5-and 10-year survival rates were 85% and 61%, respectively, in patients with early HCC, which was significantly better than in patients with small advanced HCC (P = 0.0137). Univariate and multivariate analysis showed Child-Pugh class, intrahepatic metastasis, and early HCC to be significant prognostic factors.


CONCLUSIONS
Patients with early HCC had a different clinical background and good surgical outcomes; therefore, it should be recognized that early HCC is a distinct clinicopathological entity.
Yamamoto
Masakazu
M
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. m-yama@jg7.so-net.ne.jp
Takasaki
Ken
K
Otsubo
Takehito
T
Katsuragawa
Hideo
H
Katagiri
Satoshi
S
Yoshitoshi
Kenji
K
Ariizumi
Shunichi
S
Saito
Akiko
A
Nakano
Masayuki
M
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome