Hepatic resection for primary liver malignancy

Abstract

The results of hepatic resection for patients with primary liver malignancy seen at our clinic during the past 21 years are reported. Of 92 patients, 57 had cirrhosis in addition to hepatocellular carcinoma, and 49 (53 percent) underwent hepatic resection of various degrees from partial resection to trisegmentectomy. Resectability rates of the liver were 52 percent in 77 patients with hepatocellular carcinoma, including 19 in whom the tumor was less than 5 cm in diameter, and 60 percent in 15 patients with other malignant tumors; operative mortality rates were 15 percent in the former and 0 percent in the latter. Cumulative survival rates of all patients who underwent hepatic resection, excluding death within one month, were 55 percent at one year, 29 at 3 and 5 years. In patients with hepatocellular carcinoma, survival rates of 15 those who had a curative resection of the tumor were 87 percent at one year and 47 percent at 3 or 5 years, there was a significant difference in survival curves between those with tumors less than 5 cm and more than 5 cm (p less than 0.05). On the other hand, survival rates of all patients with other malignant tumors were 78 percent at one year and 37 percent at 5 years. These results indicate the importance of performing hepatic resection for patients with small hepatocellular carcinoma associated with cirrhosis and those with other malignant tumors.

Hepatic resection for hepatocellular carcinoma associated with liver cirrhosis

“…The rate of the latter is similar to that of 37.2% in the patients reported by Shinagawa and associates [9] and shows that follow-up examination in patients with cirrhosis or chronic hepatitis is important. As mentioned in many reports [9,10], cirrhotic patients with hepatoma obviously reveal a hypofunction of the liver, and there is some difference in liver function between cirrhotic and noncirrhotic patients [11]. As a part of our laboratory examinations to evaluate the operative risk in patients with liver tumor, the measurement of ICG Rmax [12,13] and the hepaplastin test are usually carried out together with other functional tests in our department.…”