Surgical resection for hepatocellular carcinoma: a single-centre’s one decade of experience

Abstract

Background and Aims: Liver cancer is the third leading cause of global cancer deaths, and hepatocellular carcinoma is its most common type. Liver resection is one of the treatment options for HCC. This study aims to explore our hospital’s more than a decade of experience in liver resection for HCC patients. Methods: This is a retrospective cohort study on HCC patients undergoing resection from 2010 to 2021 in a tertiary-level hospital in Jakarta, Indonesia. Mortality rates were explored as the primary outcome of this study. Statistical analysis was done on possible predictive factors using Pearson’s Chi-Square. Survival analysis was done using the Log-Rank test and Cox Regression. Results: 91 patients were included in this study. We found that the post-operative mortality rates were 8.8% (in-hospital), 11.5% (30 days), and 24.1% (90 days). Excluding post-operative mortalities, the long-term mortality rates were 44.4% (first year), 58.7% (three-year), and 69.7% (five-year). Cumulatively, the mortality rates were 46.4% (one-year), 68.9% (three-year), 77.8% (five-year), and 67.0% (all-time). Significant predictive factors for cumulative one-year mortality include large tumor diameter (OR 14.06; 95% CI: 2.59-76.35; comparing <3 cm and >10 cm tumors; P<0.01), positive resection margin (OR 2.86; 1.17-77.0; P=0.02), and tumor differentiation (P=0.01). Multivariate analysis found hazard ratios of 6.35 (2.13-18.93; P<0.01) and 1.81 (1.04-3.14; P=0.04) for tumor diameter and resection margin, respectively. Conclusion: The mortality rate of HCC patients undergoing resection is still very high. Significant predictive factors for mortality found in this study benefit from earlier diagnosis and treatment; thus, highlighting the importance of HCC surveillance programs.