title: Trends in surgical results of hepatic resection for hepatocellular carcinoma: 1,000 consecutive cases over 20 years in a single institution.
abstract: BACKGROUND
  Surgical results have been reported to be improved in hepatic resections for hepatocellular carcinoma (HCC) in recent years, but the detailed trends in surgical results for HCC in a single high-volume center are still not clear.
  
  
  METHODS
  Surgical results in 1,000 hepatic resections for HCC performed at a single medical center from 1989 to 2011 were analyzed. Patients were divided into 3 groups: those performed in the early period (1989 to 1995, n = 181), the middle period (1996 to 2004, n = 391), and the late period (2005 to 2011, n = 428).
  
  
  RESULTS
  Hospital mortality (3.9%, 1.0%, and .5%; P = .0027) and morbidity (45%, 24%, and 15%; P < .0001) rates were significantly decreased. The overall survival rates were significantly improved (50%, 72%, and 78% at 5 years; P = .0021), but there was no significant difference in the disease-free survival (29%, 34%, and 31% at 5 years; P = .7823).
  
  
  CONCLUSIONS
  Surgical results of hepatic resections for HCC were significantly improved, with the mortality rate nearly reaching 0%. The 5-year survival rate after hepatic resections for HCC was also improved to 78%, but the consistently high rate of HCC recurrence after hepatic remains a problem.
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: yamashi@surg2.med.kyushu-u.ac.jp.
authors.forename: Yo-ichi
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsuijita
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takeishi
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Ishida
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Ezaki
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Nagasue
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000401:mortality* / Q000639:trends; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: 5-year disease-free survival; 5-year survival; Hepatic resection; Hepatocellular carcinoma; Morbidity and mortality