Original communication| Volume 113, ISSUE 6, P612-618, June 1993

Postresection prognosis of patients with hepatocellular carcinoma

      This paper is only available as a PDF. To read, Please Download here.


      Background and Methods. Between July 1973 and December 1990, 137 patients with hepatocellular carcinoma underwent potentially curative resection at our institution and were discharged from the hospital. The factors that contributed to long-term survival were studied by univariate and multivariate analyses.
      Results and Conclusions. The 5-year actuarial survival rate was 49%. Univariate analysis showed that smaller tumor, limited resection, wide margin, absence of tumor thrombus in the portal vein or intrahepatic metastases, and absence of tumor thrombus in the hepatic vein were favorable signs for long-term survival. Multivariate analysis revealed that wide margin and absence of tumor thrombus in the hepatic vein were significant factors. Currently, 26 patients have survived more than 5 years after operation. However, 20 (76.9%) of the 26 patients have had recurrence. The 5-year disease-free survival rate of the 137 patients is 19%. Most recurrences occurred within 3 years after operation and were observed in the remnant liver. Univariate analysis of contributory factors to disease-free survival showed that wide margin, absence of tumor thrombus in the portal vein or intrahepatic metastases, and absence of tumor thrombus in the hepatic vein were favorable signs. Multivariate analysis disclosed that wide margin and absence of tumor thrombus in the hepatic vein were significant factors.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Tsuzuki T
        • Sugioka A
        • Ueda M
        • et al.
        Hepatic resection for hepatocellular carcinoma.
        Surgery. 1990; 107: 511-520
        • Healey Jr., J.E.
        Clinical anatomic aspects of radical hepatic surgery.
        J Internat Coll Surgeons. 1954; 22: 542-550
        • Tsuzuki T.
        • Kawada K.
        • Ueda M.
        • et al.
        Hepatocellular carcinoma with tumor thrombus extending into the right atrium: report of a successful resection.
        Jpn J Gastrointest Surg. 1991; 24: 2236-2240
        • Liver Cancer Study Group of Japan
        The general rules for the clinical and pathological study of primary liver cancer.
        in: 2nd ed. Kanehara, Tokyo1987
        • UICC
        TNM classification of malignant tumours.
        4th ed. Springer-Verlag, Berlin1987
        • Tang Z.-Y.
        • Yu Y.-Q.
        • Zhou X.-D.
        • et al.
        Surgery of small hepatocellular carcinoma: analysis of 144 cases.
        Cancer. 1989; 64: 536-541
        • Chen M.-F.
        • Hwang T.-L.
        • Jeng L.-B.B.
        • Jan Y.-Y.
        • Wang C.-S.
        • Chou F.-F.
        Hepatic resection in 120 patients with hepatocellular carcinoma.
        Arch Surg. 1989; 124: 1025-1028
        • Hsu H.-C.
        • Sheu J.-C.
        • Lin Y.-H.
        • et al.
        Prognostic histologic features of resected small hepatocellular carcinoma (HCC) in Taiwan: a comparison with resected large HCC.
        Cancer. 1985; 56: 672-680
        • Lai E.C.S.
        • Ng O.L.
        • Path M.R.C.
        • et al.
        Hepatectomy for large hepatocellular carcinoma: the optimal resection margin.
        World J Surg. 1991; 15: 141-145
        • Yoshida Y
        • Kanematsu T
        • Matsumata T
        • Takenaka K
        • Sugimachi K
        Surgical margin and recurrence after resection of hepatocellular carcinoma in patients with cirrhosis: further evaluation of limited hepatic resection.
        Ann Surg. 1989; 209: 297-301
        • Kemney F
        • Vadrot J
        • Wu A
        • Smardja C
        • Meakins J.L.
        • Franco D
        Morphological and histological features of resected hepatocellular carcinoma in cirrhotic patients in the west.
        Hepatology. 1989; 9: 253-257
        • Sugioka A
        • Tsuzuki T
        Post-resection prognosis of patients with hepatocellular carcinoma from the viewpoint of a new gross classification of the tumor.
        in: Program and abstracts of the Thirty-fourth World Congress of Surgery, International Society of Surgery, Stockholm, SwedenAugust 1991
        • Yamanaka N
        • Okamoto E
        • Toyosaka A
        • et al.
        Prognostic factors after hepatectomy for hepatocellular carcinoma: a univariate and multivariate analysis.
        Cancer. 1990; 65: 1104-1110
        • Hsu H.-C.
        • Wu T.-T.
        • Wu M.-Z.
        • Sheu J.-C.
        • Lee C.-S.
        • Chen D.-S.
        Tumor invasiveness and prognosis in resected hepatocellular carcinoma: clinical and pathogeneric implications.
        Cancer. 1988; 61: 2095-2099
        • Nakashima T
        Vascular changes and hemodynamics in hepatocellular carcinoma.
        in: Okuda K Peters R.L. Hepatocellular carcinoma. Wiley, New York1976: 169-203
        • Lai E.C.-S.
        • Ng I.Q.-L.
        • Ng M.M.-T.
        • et al.
        Long-term results of resection for large hepatocellular carcinoma: a multivariate analysis of clinicopathological features.
        Hepatology. 1990; 11: 815-818
        • Nonami T
        • Isshiki K
        • Katoh H
        • et al.
        The potential role of postoperative hepatic artery chemotherapy in patients with high risk hepatoma.
        Ann Surg. 1991; 213: 222-226
        • Matsumata T
        • Kanematsu T
        • Takenaka K
        • Yoshida Y
        • Nishizaki T
        • Sugimachi K
        Patterns of intrahepatic recurrence after curative resection of hepatocellular carcinoma.
        Hepatology. 1989; 9: 457-460
        • Nagasue N
        • Yukaya H
        • Chang Y.-C.
        • et al.
        Assessment of pattern and treatment of intrahepatic recurrence after resection of hepatocellular carcinoma.
        Surg Gynecol Obstet. 1990; 171: 217-222
        • Nagao T
        • Inoue S
        • Yoshimi F
        • et al.
        Postoperative recurrence of hepatocellular carcinoma.
        Ann Surg. 1990; 211: 28-33
        • Belghiti J
        • Panis Y
        • Farges O
        • Benhamou J.P.
        • Fekete F
        Intrahepatic recurrence after resection of hepatocellular carcinoma complicating cirrhosis.
        Ann Surg. 1991; 214: 114-117
        • Matsumata T
        • Kanematsu T
        • Tanaka K
        • Sugimachi K
        Lack of intrahepatic recurrence of hepatocellular carcinoma by temporary portal venous embolization with starch microspheres.
        Surgery. 1989; 105: 188-191
        • Ackerman N
        • Nallathambi M.N.
        • Patel K.R.
        • Panchacharum P.
        • Williams S.E.
        Second hepatoma developing 13 years after resection of first tumor.
        Arch Surg. 1986; 121: 726-728
        • Penn I.
        Hepatic transplantation for primary and metastatic cancers of the liver.
        Surgery. 1991; 110: 726-735