Prognosis of Patients with Hepatocellular Cancer following Hepatectomy and the Effectiveness of Postoperative Regional Chemotherapy

Ryohei lzumi, Kohichi Shimizu, Toshio Watanabe, Kazuhisa Yabushita, Hajime Horichi, Kazuo Kitabayashi, Takashi Tani, Masato Kiriyama, Itsuo Miyazaki

Department of Surgery II, School of Medicine, Kanazawa University

Eighty nine patients with hepatocellular cancer underwent hepatectomy, including nine patients with operative deaths and six with hospital deaths. The postoperative disease free cumulative survival rates for the 73 patients who did not die in the hospital were calculated according to the mode of cancer invasion, which was diagnosed histologically and the method of hepatectomy to determine whether or not complete cure was achieved by hepatectomy. Staging was performed by the general rules of primary liver cancer of the Japanese Liver Cancer Study Group. Thirteen of the patients, who did not succumb to operative death were treated by postoperative intra-hepato-arterial infusion chemotherapy and/or transcatheter arterial embolization with Lipiodol and Gelfoam. The cumulative survival rate for patients who received postoperative regional chemotherapy (n=13) was compared with that of patients who did not receive the therapy (n=67). The significantly good prognostic factors in patients who underwent hepatectomy were a small tumor (less than 2 cm in diameter) and absence of capsule invasion, absence of portal invasion, absence of intrahepatic metastasis and absence of cancer involvement of the liver stump. No significance was found concerning the method of hepatectomy, capsule formation and hepatic vein invasion. Cumulative 3-year survival rates were 83.3% and 49.3% for patients treated by postoperative regional chemotherapy and those who did not receive regional chemotherapy. This difference is significant, suggesting that postoperative regional chemotherapy is effective for prolonging the survival of patients who undergo hepatectomy.

Key words
hepatocellular cancer, disease free survival after hepatectomy, postoperative regional chemotherapy, transcatheter arterial embolization

Reprint requests
Ryohei Izumi Department of Surgery, II, School of Medicine, Kanazawa University
13-1 Takara-machi, Kanazawa, 920 JAPAN

Accepted
October 11, 1989

To read the PDF file you will need Abobe Reader installed on your computer.