Kosuge T, Makuuchi M, Takayama T, Yamamoto J, Shimada K, Yamasaki S
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Hepatogastroenterology. 1993 Aug;40(4):328-32.
The long-term outcome in 480 patients with primary hepatocellular carcinoma (HCC) who underwent hepatic resection between 1980 and 1990 was investigated. Overall 5- and 10-year survival rates were 44.1% and 17.8%, respectively, with a hospital mortality rate of 3.1%. The survival of patients who underwent curative resection was better than that of patients treated with noncurative resection. Tumor invasiveness, defined by the presence of vascular invasion and/or intrahepatic metastases, was a major prognostic factor for early recurrence in the patients treated with curative resection. The effect of tumor size and number on prognosis was attributable to a strong correlation with tumor invasiveness. One-third of patients with multiple lesions were considered to have multicentric disease, and their prognosis was better than that of patients with invasive lesions. The width of the resection margin did not affect the prognosis. An unfavorable effect of associated liver disease, especially cirrhosis, was prominent in the later period. A beneficial effect of anatomically systematic resection was apparent in non-cirrhotic patients with non-invasive HCC.
对1980年至1990年间接受肝切除术的480例原发性肝细胞癌（HCC）患者的长期预后进行了研究。总体5年和10年生存率分别为44.1%和17.8%，医院死亡率为3.1%。接受根治性切除术患者的生存率优于接受非根治性切除术的患者。肿瘤侵袭性由血管侵犯和/或肝内转移的存在来定义，是接受根治性切除术患者早期复发的主要预后因素。肿瘤大小和数量对预后的影响归因于与肿瘤侵袭性的强烈相关性。三分之一的多发灶患者被认为有多中心疾病，其预后优于有侵袭性病灶的患者。切缘宽度不影响预后。相关肝脏疾病，尤其是肝硬化的不利影响在后期较为突出。解剖学上的系统性切除术对无肝硬化的非侵袭性HCC患者有明显的有益效果。
