A Study of Operative Treatment for Hepatocellular Carcinoma with Special Reference to Recurrence after Surgery.

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  • Yogita Shiro
    First Department of Surgery, School of Medicine, Tokushima University
  • Fukuda Yoh
    First Department of Surgery, School of Medicine, Tokushima University
  • Ohnishi Takahito
    First Department of Surgery, School of Medicine, Tokushima University
  • Ishikawa Masashi
    First Department of Surgery, School of Medicine, Tokushima University
  • Harada Masamitsu
    First Department of Surgery, School of Medicine, Tokushima University
  • Wada Daisuke
    First Department of Surgery, School of Medicine, Tokushima University
  • Tashiro Seiki
    First Department of Surgery, School of Medicine, Tokushima University

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  • 再発からみた肝細胞癌に対する手術術式に関する検討

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Abstract

The operative treatment of hepatocellular carcinoma (HCC) was examined in 55 patients with attention to recurrence after surgery. They underwent hepatic resection for hepatocellular carcinoma (HCC) and were followed up for one and a half years postoperatively. Three patients were excluded: one operative death (1.8%), and two patients with unequivocally noncurative disease. The overall recurrence rate was 46.2%. There were 22 recurrences in the remnant liver, and 87.5% of them had been recurred less than 18 months after surgery. Three patients had recurrences at the surgical margin. All of these patients had residual disease at the surgical margin (TW+) at the time of resection. Two had tumors larger than 5 cm in diameter. The 5-year survival rate was 23.0% in the patients who underwent curative resection (n=28) and 70.8% in the patients who underwent noncurative resection (n=24). The recurrence rates were 53.6% and 37.5%, respectively. Extent of tumor greater than resection (H>Hr) was the most common reason for non-curative resection. Resection less than a subsegmentectomy (HrO) were assosiated with a lower recurrence rate than resection of one or more segments. Furthermore, compared with subsegmentectomy for HCC less than 5 cm in diameter, HrS was not associated with better recurrence and survival rates. However, these differences were not significant. We conclude that extended hepatectomy is required for the treatment of HCC larger than 5 cm. On the other hand, tumors less than 5cm can be treated with limited resection.

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