title: Prognostic impact of hepatic resection for hepatocellular carcinoma: the role of the surgeon in achieving R0 resection--a retrospective cohort study.
abstract: BACKGROUND
  Improvement in long-term survival of patients with hepatocellular carcinoma (HCC) has followed the developments in surgical techniques and multidisciplinary therapies. The role of the surgeon has rarely been studied and to fill this research gap we offer this study which has reviewed the outcome of surgery in attempted curative resection for this condition.
  
  
  METHODS
  The clinical data of patients who underwent partial hepatectomy for HCC from January 2003 to December 2010 at the First People's Hospital of Foshan were collected and retrospectively analyzed.
  
  
  RESULTS
  Of 104 HCC patients, the 1-, 3-, and 5-year disease free survival (DFS) rates were 64.8%, 45.5%, and 38.5%, respectively, and the 1-, 3-, and 5-year overall survival (OS) rates were 86.3%, 63.6%, and 57.2%, respectively. Negative resection margin and tumor TNM stage were independent prognostic factors of DFS and OS (P<0.0001).
  
  
  CONCLUSIONS
  Negative resection margin and tumor TNM stage were the two most significant prognostic factors of survival in HCC patients after partial hepatectomy. As TNM stage is a factor not subjected to control, surgeons can improve the long-term survival of patients with HCC by ensuring an appropriate negative resection margin.
authors.affiliation: Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Guang Dong, China. Electronic address: chwei_fsyyy@163.com.
authors.forename: Chen
authors.initials: C
authors.lastname: Huan-Wei
authors.affiliation: Department of Statistics, The First People's Hospital of Foshan, Guang Dong, China.
authors.forename: Liao
authors.initials: L
authors.lastname: Shan
authors.affiliation: Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Guang Dong, China; Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Lau
authors.initials: L
authors.lastname: Wan-Yee
authors.affiliation: Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Guang Dong, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Feng-Jie
authors.affiliation: Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Guang Dong, China.
authors.forename: Deng
authors.initials: D
authors.lastname: Fei-Wen
authors.affiliation: Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Guang Dong, China; Department of Surgery, Pamela YoudeNethersole Eastern Hospital, Hong Kong SAR, China.
authors.forename: Lai Eric
authors.initials: LE
authors.lastname: Chun-Hung
authors.affiliation: Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Guang Dong, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zuo-Jun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D002983:Clinical Competence; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D066231:Surgeons / Q000592:standards; D015996:Survival Rate
keywords: Hepatectomy; Hepatocellular carcinoma; Liver disease; Resection margin; TNM stage