Analysis of Long-Term Survival and Disease Free Survival after Liver Resection for Hepatocelluar Carcinoma

Yun, Hae Ran; Lee, Kwang Woong; Heo, Jin Seok; Choi, Sung Ho; Kim, Sung Ju; Kim, Yong Il; Joh, Jae Won

Abstract

PURPOSE
Liver resection has been the treatment of choice for a hepatocellular carcinoma (HCC) but the survival rates remain low, and recurrences common. The purpose of this study was to evaluate the prognostic factors that could affect the overall and disease free survivals of HCC. METHODS: Five hundred ten and liver resections for HCC, conducted 1994- and -2001, were retrospectively reviewed. They subjects consisted of 409 men and 101 women with a median age of 51.2 years, (ranging: from 10- to 88-). Univariate and multivariate analyses were performed on several of the clinicopathological variables in order to find factors affecting the overall and disease free survivals. The statistical analyses were performed using the Kaplan-Meier method, Log-rank test and Cox regression hazard model, with SPSS 11.0 for Windows. RESULTS: The 1-, 3-, 5- year overall survival rates were 85, 68 and 54%, and the 1-, 3-, 5- year disease free survival rates were 61, 42 and 34%, respectively. Tumor recurrence occurred in 314 patients (61.6%) and was the main cause of death in 205 (56%). The independent prognostic factors for overall survival were ICGR15, tumor capsule formation and size. Furthermore, the independent prognostic factors for disease free survival were alfa-feto protein (AFP), transfusion, tumor capsule formation, size and venous emboli. CONCLUSION: HCC is one of the most common malignancies worldwide, and a partial hepatectomy is a safe, effective, and potentially curative therapy. However, the postoperative recurrence rate remains high rate. The prudent evalulation of patients factors of survival and recurrence is required before an operation and high risk patients should be followed up more carefully.