J Korean Surg Soc.  2010 Jan;78(1):29-34. 10.4174/jkss.2010.78.1.29.

Comparison of Surgical Outcomes and Long-term Survival between Limited and Major Hepatic Resection for Hepatocellular Carcinoma Less than 5 cm

• Kim HJ
• Yoon JH
• Kim JY
• Kwon HJ
• Kim GS
• Chun JM
• Kim SG
• Yun YK

• KMID: 1775442
• DOI: http://doi.org/10.4174/jkss.2010.78.1.29

Abstract

PURPOSE: Though major hepatic resections including hemihepatectomy, trisectionectomy, and central bisectionectomy are most commonly employed for small (<5 cm) hepatocellular carcinoma (HCC), limited hepatic resection is indicated in some HCC patients with impaired liver function, poor physical condition, or tumors peripherally located. We compared the clinicopathological features and long-term survival between the patients who underwent major resection and limited resection.
METHODS
From January 1998 to May 2007, 223 patients who underwent hepatic resection for small HCC were enrolled. 123 patients underwent limited resection and 100 patients underwent major resection. Clinocopathologic features, overall, and disease-free survival were compared between both groups.
RESULTS
The limited resection group had lower mean serum albumin levels (3.86+/-0.41 vs. 4.11+/-3.61, P<0.0001) and higher mean ICG R15 (12.66+/-0.87 vs. 7.51+/-4.33, P<0.0001). Patients with esophageal varix and liver cirrhosis were more common in the limited resection group (34.1% and 73.1% versus 9% and 45% respectively). Morbidity and mortality were not different in both groups. Overall 1-, 3-, 5-year survivals in both limited resection and major resection groups were 89.4%, 77.3%, 43.8% and 87.8%, 76.5%, 62.1% respectively (P=0.161) and 1-, 3-, 5-year disease free survivals were 80.2%, 50.2%, 38.6% and 79.9%, 63.2%, 50.4% respectively (P=0.10).
CONCLUSION
Despite indifference of overall and disease-free 5-year survival rates between limited and major resection groups, careful follow up is essential to detect late recurrence in the limited resection group, since limited resection tends to have more frequent recurrence, especially 2 years after surgery.

Keyword

Hepatocellular carcinoma; Limited hepatectomy; Major hepatectomy

MeSH Terms

Carcinoma, Hepatocellular
Disease-Free Survival
Esophageal and Gastric Varices
Follow-Up Studies
Humans
Liver
Liver Cirrhosis
Recurrence
Serum Albumin
Survival Rate
Serum Albumin

Figure

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  Fig. 1 Overall (A) and disease free (B) 1-, 3-, 5-year survivals in limited resection and major resection were not different statistically.

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