The efficacy of liver resection for multinodular hepatocellular carcinoma.
OBJECTIVE
The aim of the present study was to evaluate the efficacy of liver resection for multinodular hepatocellular carcinoma (MNHCC).


METHODS
A total of 399 patients who underwent R0 resection for HCC from 1992 to 2011 were subjected to analysis. Out of these 399 patients, 107 patients had multinodular HCC, while 292 had a single tumor.


RESULTS
The 3- and 5-year overall survival rates of patients with MNHCC were 62.0% and 38.1% respectively. By a multivariate analysis of the survival of the 107 patients after liver resection for MNHCC, it was shown that the presence of four or more tumors and a lower serum albumin level were unfavorable prognostic factors for long-term survival. With respect to the patients with four or more HCCs, portal vein invasion was an independent unfavorable prognostic factor for long-term survival. However, in patients with four or more HCCs without portal vein invasion, overall survival rates of those with preoperative serum albumin level >4.0 mg/dl and a platelet count >10(5)/mm(3) were significantly higher than those of patients with albumin <4.0mg/dl or platelet count <10(5)/mm(3) (p=0.049).


CONCLUSIONS
Liver resection can provide a survival benefit, even for patients with multiple HCCs. Even if patients have four or more tumors without portal vein invasion and with well-preserved liver function, resection for HCC may be the treatment of choice.
Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, 236-0004 3-9 Fukuura, Kanazawa-ku, Yokohama City, Japan. kazunojiri@gmail.com.
Kazunori
K
Nojiri
Kuniya
K
Tanaka
Kazuhisa
K
Takeda
Michio
M
Ueda
Ryusei
R
Matsuyama
Kouichi
K
Taniguchi
Takafumi
T
Kumamoto
Ryutarou
R
Mori
Itaru
I
Endo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome
Multinodular hepatocellular carcinoma; liver function; liver resection