術前肝機能と肝切除量の原発性肝細胞癌術後長期遠隔成績への影響

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  • The Effects of Preoperative Liver Function and Resected Segment on the Outcome of the Patients with Hepatocellular Carcinoma.

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The survival and disease-free survival curve of 534 patients with solitary hepatocellular carcinoma (HCC) who underwent hepatectomy were applied to parametric survival analysis models. The 3-, 5-, 10-years survival and the 3-, 5-, 10-years disease-free survival rate of the patients were 76, 60, 34% and 46, 32, 16%, re-pectively. Both of the curves were well applied to Weibull and Log-logistic model. The significant coefficients which affect the survival curve were preoperative ICG R15 and tumor size. Lower ICG R15 and smaller tumor size improved survival rate. Similarly, preoperative ICG R15, tumor size and resected segment were significant coefficients for the disease-free survival curve. Lower ICG R15, smaller tumor size and larger hepatectomy prolonged disease-free period. Although, the extension of hepatectomy improves disease-free survival, better survival is obtained by better liver function rather than larger hepatectomy. It is concluded that the optimum hepatectomy preserving liver function is important for long term QOL of HCC patients.

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