Results of 280 liver resections for hepatocellular carcinoma.

OBJECTIVE

To evaluate the recent results of liver resection in patients with hepatocellular carcinoma.

DESIGN

Retrospective study.

SETTING

A university hospital in Japan.

PATIENTS

Two hundred eighty patients who underwent liver resection with complete extirpation of hepatocellular carcinoma from 1985 to 1993.

MAIN OUTCOME MEASURES

Morbidity and survival after operation and the pathologic features of hepatocellular carcinoma according to the TNM classification of the International Union Against Cancer.

RESULTS

More than 40% of the patients with stages I and II disease underwent a partial resection of the liver, whereas 50% of those with stages III and IVA were operated on with more than a bisegmentectomy. Fifty percent of all patients had no postoperative complications. The morbidities included intra-abdominal abscess (7%), bile leakage (5%), and hepatic failure (4%, of whom half died; mortality rate, 2%). Histopathologically, 32% of the stage I tumors were well differentiated (grade 1), while, in stage III, 56% had portal invasion and 61% had daughter lesions in the liver. The cumulative survival rates of patients with stages I, II, and III disease and all patients at 5 years were 69%, 52%, 32%, and 50%, respectively, while the disease-free survival rates at 5 years were 38%, 34%, 17%, and 29%, respectively.

CONCLUSION

The recent results of liver resection for hepatocellular carcinoma are generally satisfactory; however, the recurrence rate is still high.