| Abstract | BACKGROUND: The aim of this study was to clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients with compensated cirrhosis surviving more than 10 years after initial hepatectomy. STUDY DESIGN: Among 250 patients who underwent hepatectomy for HCC between 1987 and 1994 at our institute, 145 patients who had Child-Pugh class A liver function and who underwent curative resection were included in this study. Clinicopathologic factors in 10-year survivors and patients who died within 10 years (nonsurvivors) were compared, and the prognostic factors affecting survival were identified. RESULTS: There were 29 patients who survived for more than 10 years after initial hepatectomy, and 9 of those patients survived without cancer recurrence. The 3-, 5-, and 10-year survival rates were 76.2%, 53.0%, and 26.9% respectively. The corresponding disease-free survival rates were 43.1%, 25.7%, and 9.9% respectively. In multivariate analysis, liver fibrosis grade F0-2, female gender, ICG-R15 value of less than 15%, and absence of microscopic vascular invasion were favorable independent factors associated with 10-year survival. Disease-free interval after initial hepatectomy in 10-year survivors with recurrence was significantly longer than that in nonsurvivors with recurrence, 5.1 and 1.9 years respectively (P = 0.0004). The number of intrahepatic recurrent nodules in 10-year survivors tended to be fewer than that in nonsurvivors. CONCLUSIONS: Based on the results of our study, liver fibrosis grade F0-2, female gender, ICG-R15 value of less than 15% and absence of microscopic vascular invasion at initial hepatectomy might be biologically favorable conditions for long-term survival. Close follow-up as well as multimodal treatment could contribute to prolongation of survival in such patients, even if HCC recurrence develops. |
| Authors | Saburo Fukuda, Toshiyuki Itamoto, Hironobu Amano, Toshihiko Kohashi, Hideki Ohdan, Hirotaka Tashiro, Toshimasa Asahara
(Affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. safukuda at aol.com)
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| Journal | World journal of surgery
(World J Surg)
Vol. 31
Issue 2
Pg. 345-52
(Feb 2007)
ISSN: 0364-2313 United States |
| PMID | 17219274
(Publication Type: Journal Article)
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| Topics |
- Adult
- Aged
- Carcinoma, Hepatocellular
(mortality, pathology, surgery)
- Disease-Free Survival
- Female
- Follow-Up Studies
- Hepatectomy
- Humans
- Liver Cirrhosis
(etiology, mortality, pathology)
- Liver Neoplasms
(mortality, pathology, surgery)
- Male
- Middle Aged
- Neoplasm Invasiveness
- Sex Factors
- Survival Rate
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