Risk factors for early death after liver resection in patients with solitary hepatocellular carcinoma.
OBJECTIVE
Although most patients who receive hepatectomy for a solitary hepatocellular carcinoma (HCC) have a relatively fair result, some have a poor prognosis. The aim of this study was to evaluate the risk factors for early death after hepatectomy in patients with a solitary HCC.


METHODS
Eligible patients (n=110) who had undergone hepatectomy for solitary HCC between 1990 and 2002 and were able to be followed up for more than 2 years after the hepatectomy were divided into two groups, those who died of cancer recurrence within 2 years (early-death group; n=18) and those who survived for more than 2 years after the surgery (survival group; n=92). Risk factors for early death after liver resection were evaluated by univariate and multivariate analyses.


RESULTS
The gross tumor classification, tumor diameter, macroscopic portal vein invasion, microscopic growth pattern, microscopic vascular invasion (MVI), and the width of the surgical margin were significant (P<0.05) factors by univariate analysis. Multivariate analysis showed that the presence of MVI was an independent and significant risk factor for early death of recurrence.


CONCLUSIONS
Among patients with solitary HCC, the presence of MVI indicates a poor prognosis. These patients need adjuvant chemotherapy in the early period after hepatectomy.
Kondo
Kazuhiro
K
First Department of Surgery, Faculty of Medicine, Miyazaki University, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
Chijiiwa
Kazuo
K
Makino
Ichiro
I
Kai
Masahiro
M
Maehara
Naoki
N
Ohuchida
Jiro
J
Naganuma
Seiji
S
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors