Results of 280 Liver Resections for Hepatocellular Carcinoma

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Abstract
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. (Arch Surg. 1996;131:71-76)