Analysis of 38 Long-Term Survivors after Liver resections for Hepatocellular Carcinomas

Hwang, In Sung; Hong, Seong Woo; Nah, Yang Won; Jang, Yeo Gu; Kim, Ki Hoon; Lee, Hyucksang

Abstract

BACKGROUND/AIMS: This study was conducted to develop an optimal strategy to achive long-term survival after liver resection for hepatocellular carcinoma.
METHODS
Between July 1975 and March 1995, 109 patients who underwent liver resection for hepatocellular carcinoma at Inje University Seoul Paik Hospital were analyzed retrospetively.
RESULTS
38 patients (34.9%) survived longer than 5 years after the operation. Prognostic factors of statistical significance were the diagnostic clue, ICG R15, TNM stage, extent of tumor, intrahepatic metastasis, portal vein thrombosis, serosal infiltration, tumor grade, resection margin, Glissonian approach, radicality of operation, cancer recurrence and disease free interval. For the 63 cases with no intrahepatic metastasis, there was no survival difference between the lobectomy group and the segmentectomy/subsegmentectomy group(36.8% vs. 50.0%). In those cases with satellite nodules in one segment of the liver, 66.7% of the lobectomy group lived longer than 5 years while 17.6% of lessthan- lobectomy group survived long-term(p=0.025).
CONCLUSION
For long-term survival, a systemic segmentectomy/ subsegmentectomy is adquate for those tumors without intrahepatic metastasis, while the presence of satellite nodules in one segment mandates a standard hepatic lobectomy.