SURGICAL-TREATMENT OF 109 PATIENTS WITH SYMPTOMATIC AND ASYMPTOMATIC HEPATOCELLULAR-CARCINOMA

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  • 1 April 1986
    • journal article
    • research article
    • Vol. 99  (4) , 481-490
Abstract
A total of 109 patients with histologically proved hepatocellular carcinoma (HCC) have undergone hepatic resection during the 56-month period from October 1978 to May 1983. There were two sources of patients: those with symptomatic HCC (n = 47) and those with asymptomatic HCC (n = 62). A family tendency of HCC was noted in 11% of the patients studied. The percent of positive hepatitis B surface antigen (HBsAg) was 87%, and the serum .alpha.-fetoprotein was less than 20 ng/ml in 30% in the group with symptoms. The operative mortality rate was 3% and the hospital mortality rate was also 3%. The postoperative course was complicated with pleural effusion of 10%, bile leakage in 4%, subphrenic abscess in 4%, and upper gastrointestinal bleeding caused by gastritis in 1% of the patients. The actual survival rate for the 103 cases was 84% for 350 days and 28% for 1400 days. However, in the group with asymptomatic HCC with an average tumor size of 3.35 .+-. 1.49 cm in diameter, the rate was 92% for 350 days and 44% for 1400 days. In the group with symptomatic HCC with an average tumor size of 10.6 .+-. 5.1 cm in diameter, the rate was 76% for 350 days and 8% for 1400 days. The survival rate of the group with asymptomatic HCC was far better than that of the group with symptoms (p < 0.05). In analysis of factors that might affect the patient''s survival, only second or third operations (p < 0.05), typical gross findings of tumor appearance (p < 0.05), and an adequate margin were closely related (p < 0.001). Neither the tumor size, that status of accompanying liver cirrhosis, the tumor location, nor the patient''s sex and age affected the patient''s survival (all p > 0.05).