肝細胞癌術後３年以内再発例からみた治癒切除判定の検討

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  • Clinical study of the recurrence after hepatectomy in cases of hepatocellular carcinoma, with a special reference to curative operation.

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Prognostic factors causing recurrence of cancer after hepatectomy were studied in patients with hepatocellular carcinoma (HCC). In order to define the criteria of “Curative Operation” for HCC, pathological features were assessed in 97 cases. HCC accompanied by portal venous invasion (Vp) and/or intrahepatic metastasis (IM) showed a poor outcome in 1-and 3-year recurrence-free survival rates; only 50.3% and 16.3%, respectively. Of the gross types, simple nodular types showed a better outcome than other types in the recurrence-free rates; 84.3% at 1 year and 53.3% at 3 years. Both gross types and sizes in surgically resected HCC were correlated with the frequency of Vp or IM; 9/24 (21.4%) in single nodular types, 17/31 (54.8%) in single nodular and perinodular types, 19/23 (82.6%) in other types, 4/16 (25.0%) in HCC less than 2cm, 20/50 (40.0%) in HCC from 2 to 5 cm and 21/30 (70.0%) in HCC more than 5 cm in size. No significant differrence was observed between relative curative operations (RC) and relative noncurative operations (RN) in the recurrence-fwfree survivals according to the “Guide Line for Clinical and Pathological Studies on Primary Hepatic Carcinoma”. On the other hand, there were stastically significant differreces in 1-and 2-year early recurrence-free rates between modified RC and RN in view of the prognostic factors, including Vp, IM and gross types.

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