Ann Hepatobiliary Pancreat Surg.  2025 Feb;29(1):11-20. 10.14701/ahbps.24-179.

Seizing tumor factors for mortality and survival outcomes following liver resection in Indonesia’s hepatocellular carcinoma patients

• Sihardo L
• Lalisang ANL
• Syaiful RA
• Putra AB
• Mazni Y
• Putranto AS
• Lalisang TJM

• KMID: 2565402
• DOI: http://doi.org/10.14701/ahbps.24-179

Abstract

Backgrounds/Aims
The 3-year mortality rate for hepatocellular carcinoma (HCC) in Indonesia was 94.4%. This underscores a significant health issue in Southeast Asia, particularly in Indonesia due to its large population. This study aimed to characterize the outcomes of liver resection for HCC at a National Referral Center in Indonesia.
Methods
Between 2010 and 2020, all patients with HCC undergoing liver resection were included as subjects. Variables collected included sex, age, hepatitis status, and tumor’s characteristics. Mortality and survival were the primary outcomes of the study.
Results
Among seventy patients, the mortality rate was 71.4%, with a median overall survival of 19.0 months (95% confidence interval [95%CI]: 6.831.2). Thirty-one patients (44.3%) had extra-large HCC tumors (> 10 cm). Those with extra-large tumors had a lower median survival of 8.0 months. Child-Pugh B and Edmonson-Steiner grade 4 were associated with an increased mortality risk, with unadjusted hazard ratios (HRs) of 2.2 (95%CI: 1.14.3, p = 0.026) and 3.2 (95%CI: 1.37.7, p = 0.011), respectively. Multivariate analysis indicated that Child-Pugh class B significantly increased the risk of mortality, with an adjusted HR of 2.3 (95%CI: 1.05.2, p = 0.046).
Conclusions
While surgical resection is feasible for tumors of any size, most clinical features are not statistically significantly associated with survival outcomes. The prevalence of extra-large tumors among Indonesian HCC patients highlights the importance of early diagnosis and intervention. Surgical intervention at an earlier stage and with better grade tumors could potentially enhance survival outcomes.

Keyword

Hepatectomy; Hepatocellular carcinoma; Mortality; Survival; Indonesia

Figure

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  Fig. 1 Extra-large tumor size (19.5 cm × 25.0 cm) resected from a patient with hepatocellular carcinoma in segments 4, 5, 6, 7, and 8.

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  Fig. 2 Survival of hepatocellular carcinoma patients following liver resection, categorized by (A) overall survival; (B) sex; (C) age at surgery; (D) hepatitis status; (E) tumor size; (F) Edmonson-Steiner grade; (G) tumor differentiation; (H) Child-Pugh classification; and (I) Barcelona Clinic Liver Cancer (BCLC) stage.

Reference

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