Background
The long-term outcome after resection of hepatocellular carcinoma is influenced by
factors related to the tumor and the underlying liver disease. The prognosis of hepatocellular
carcinoma is worse in hepatitis C virus antibody-positive patients than in hepatitis
B surface antigen-positive patients. In patients with hepatitis C virus infection
and hepatocellular carcinoma, the optimum extent of operative resection, i.e., limited
versus anatomic, remains controversial.
Methods
Among 247 patients with hepatitis C virus infection who underwent curative resection
of hepatocellular carcinoma between 1992 and 2003, 213 patients received limited resection
and 34 patients had anatomic resection of at least two Couinaud subsegments with complete
removal of the portal territory containing the tumor. The clinical characteristics,
operative results, and long-term survival of these two groups were compared.
Results
Although the patients receiving limited resection had significantly worse preoperative
liver function than the patients undergoing anatomic resection, the postoperative
liver function of the limited resection group was significantly better. The mortality
and morbidity rates were not significantly different after limited and anatomic resection.
Disease-free survival and overall survival were similar after both types of resection,
as were the incidence and pattern of intrahepatic tumor recurrence.
Conclusions
In patients with hepatitis C virus infection and hepatocellular carcinoma, anatomic
resection does not provide any significant benefit and should not be carried out unless
it is technically necessary. In patients with a limited hepatic functional reserve,
removal of the tumor with preservation of the liver parenchyma may take priority over
wide resection.
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Article info
Publication history
Accepted:
August 30,
2005
Identification
Copyright
© 2006 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
