HEPATIC RESECTION FOR HEPATOCELLULAR-CARCINOMA - AN AUDIT OF 343 PATIENTS

Objective The authors summarize the results of patients who had hepatectomy for hepatocellular carcinoma over a 22-year period. Summary Background Data Recent reports showed improved perioperative results and long-term prognosis. Methods The perioperative outcome of 343 patients was studied according to three different time periods: before 1987 (n = 149); 1987 to 1991 (n = 128); and 1992 to present (n = 66). Survival analysis was made by stratifying patients into two categories-either before or after 1987. The majority of patients had large tumors (78%), cirrhosis (73%), and a major hepatectomy (73%). Results Besides an increased resectability rate (23%), there was a marked reduction of the recent morbidity (32%; p < 0.001), operative (4.5%; NS) and hospital (6%; p < 0.02) mortality rates. The recent surgical approach was identified as a significant contributory factor to the lowered hospital mortality rate. Patients in the latter part of the study had significantly better survival, with a 1-, 3- and 5-year survival rate of 68%, 45%, and 35%, respectively. Early detection and effective treatment of recurrences contributed to the improved prognosis. Conclusions The recent management strategy and technological advances improved the results of surgical treatment for patients with hepatocellular carcinoma.