Surgical Management of 100 Primary Carcinomas of the Liver; Prognostic factors after hepatic resection for primary liver cancer

M. Yamamura, S. Uetsuji, Y. Okuda, K. Yamamichi, Y. Kise, H. Komada, M. Kwon, Yoshiaki Inada, T. Minoura, Takeo Yamada, M. Yamamoto
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Abstract

Between January 1980 and December 1989, surgical treatment of primary liver cancer was performed in 100 cases including two reoperations. Of these 89 were male and 11 female ; their ages ranged from 5 months to 74 years. Pathological findings showed that 92 of the patients had hepatocellular carcinoma, 6 cholangiocellular carcinoma, and 2 hepatoblastoma ; in 85% of the cases these were associated with cirrhosis. Of the 100 patients, 52 underwent typical resection of the liver, 28 limited resection, and 20 no resection. Follow-up results in resected cases showed that the cumulative survival rates at 1, 3, and 5 years were 66. 6%, 46.7%, and 36. 7%, respectively. Non-resected patients died within 3 years. Various factors w ere evaluated by analysis in respect to cumulative survival, after exclusion of operative deaths, to clarify prognosis after hepatic resection. Factors affecting the outcome were gross tumor findings including tumor size. A better prognosis was associated with encapsulated nodular forms, a tumor size of less than 2cm, and no portal vein and hepatic serosal involvement in the resected specimen.
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100例原发性肝癌的外科治疗原发性肝癌肝切除术后预后因素分析
1980年1月至1989年12月间,我们对100例原发性肝癌进行了外科治疗,其中包括2例再手术。其中男性89人,女性11人;他们的年龄从5个月到74岁不等。病理结果显示:肝细胞癌92例,胆管细胞癌6例,肝母细胞瘤2例;85%的病例伴有肝硬化。100例患者中,52例行典型肝切除,28例行有限肝切除,20例未行肝切除。对切除病例的随访结果显示,1年、3年和5年的累计生存率为66。6%, 46.7%和36。7%,分别。未切除的患者在3年内死亡。在排除手术死亡后,通过分析累积生存率来评估各种因素,以明确肝切除术后的预后。影响结果的因素是肿瘤的大体表现,包括肿瘤大小。切除标本中包封的结节形式,肿瘤大小小于2cm,未累及门静脉和肝浆膜,预后较好。
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