Views: 1,394 | Downloads:
24
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Resection of Hepatocellular Carcinoma : Personal Experience with 67 Patients and Long-Term Results
Khuhaprema T 
Hepatocellular carcinoma (HCC) is the most common cancer in Thailand. Hepatic resection
has been accepted as the only chance for cure. However; very limited information about the
operative treatment and survival of HCC in Thailand has been documented.
The author reviewed the experiences of surgical treatment of HCC at the National
Cancer Institute, Bangkok and reports herein the long term outcome.
From January 1986 to January 1996 a total of 884 primary liver cancers admitted in our
institute were reviewed. 112 consecutive hepatic resections were performed by the author. 67
of 112 patients were HCC of which clinical features, survival rate and recurrence were studied.
Liver cirrhosis was associated in 49 patients (73.I% ). HBsAg was positive in 58 patients
(86.6%). Preoperative AFP level was more than 400 ng/ml in 35 patients. The resectability for
HCC was II.O per cent. In 50 of 67 hepatic resection, major hepatic resection were carried out.
Postoperative major complications were found in I4 patients (20.9% ). Postoperative mortality
rate of 5 patients was 7.5 per cent. Survival curve was calculated by Kaplan-Meier with the
overall survival rate at I, 2, 3, 4, 5 years was 63.2 per cent, 28.6 per cent, 21.1 per cent, 14.5 per
cent and II.5 per cent respectively. I, 3, 5 years survival rate for a tumor less than 5 em was 91.0
per cent, 57.0 per cent, 49.4 per cent, tumor size of 5-IO em was 57.5 per cent, I6.0 per cent, 9.0
per cent and tumor size more than 10 em was 52.2 per cent, 0 per cent, 0 per cent. A significant
difference in survival rate was observed by size. Postoperative recurrences were observed in 45
patients (67.2%) and 82.8 per cent of the patients had intrahepatic recurrence within 2 years.
Hepatic resection is an appropriate treatment for a tumor less than I 0 em. However, a
tumor larger than I 0 em should be considered for multimodality approaches. Intrahepatic
recurrence is high and similar to the reports from the Orient. Close follow-up with prompt
treatment for recurrence is the important factor to obtain better results.
Key word : Hepatocellular Carcinoma, Hepatic Resection, Long-Term Result
has been accepted as the only chance for cure. However; very limited information about the
operative treatment and survival of HCC in Thailand has been documented.
The author reviewed the experiences of surgical treatment of HCC at the National
Cancer Institute, Bangkok and reports herein the long term outcome.
From January 1986 to January 1996 a total of 884 primary liver cancers admitted in our
institute were reviewed. 112 consecutive hepatic resections were performed by the author. 67
of 112 patients were HCC of which clinical features, survival rate and recurrence were studied.
Liver cirrhosis was associated in 49 patients (73.I% ). HBsAg was positive in 58 patients
(86.6%). Preoperative AFP level was more than 400 ng/ml in 35 patients. The resectability for
HCC was II.O per cent. In 50 of 67 hepatic resection, major hepatic resection were carried out.
Postoperative major complications were found in I4 patients (20.9% ). Postoperative mortality
rate of 5 patients was 7.5 per cent. Survival curve was calculated by Kaplan-Meier with the
overall survival rate at I, 2, 3, 4, 5 years was 63.2 per cent, 28.6 per cent, 21.1 per cent, 14.5 per
cent and II.5 per cent respectively. I, 3, 5 years survival rate for a tumor less than 5 em was 91.0
per cent, 57.0 per cent, 49.4 per cent, tumor size of 5-IO em was 57.5 per cent, I6.0 per cent, 9.0
per cent and tumor size more than 10 em was 52.2 per cent, 0 per cent, 0 per cent. A significant
difference in survival rate was observed by size. Postoperative recurrences were observed in 45
patients (67.2%) and 82.8 per cent of the patients had intrahepatic recurrence within 2 years.
Hepatic resection is an appropriate treatment for a tumor less than I 0 em. However, a
tumor larger than I 0 em should be considered for multimodality approaches. Intrahepatic
recurrence is high and similar to the reports from the Orient. Close follow-up with prompt
treatment for recurrence is the important factor to obtain better results.
Key word : Hepatocellular Carcinoma, Hepatic Resection, Long-Term Result
Download:
PDF