Evaluation of Resection Method for Hepatocellular Carcinoma Combined with Liver Cirrhosis According to Multicentric Carcinogenesis and Quality of Life

Koji Okuda, Hideki Saitsu, Toshimichi Nakayama

Second Department of Surgery, Kurume University School of Medicine

Partial resection and systematic resection for hepatocellular carcinoma combined with liver cirrhosis were evaluated according to postoperative metachronous multicentric carcinogenesis and postoperative quality of life (QOL). The 5-year survival rate was 45.0% after partial resection and 42.9% after systematic resection; there was no significant difference between the rates. According to the comparison of histologic grade of the resected tumor and recurrence of the tumor in 24 patients, in 14 patients (58.3%) recurrence was due to postoperative metachronous multicentric carcinogenesis and in 9 patients (37.5%) it was due to metastasis. In 7 of these 9 patients, the site of the recurrent tumor was a different segment from that of the resected tumor, even though the recurrence was due to metastasis. The length of hospitalization for resection and the total postoperative hospitalization was investigated and the hospitalization tended to be longer in patients who received systematic resection or who also had severe liver cirrhosis. These results indicate that systematic resection, such as subsegmentectomy or segmentectomy, should not be performed only to prolong life but also to improve the QOL. However, there was no correlation of QOL scores from our assessment with the resection method nor the degree of liver cirrhosis. The difficulty of an objective evaluation of QOL in patients with hepatocallualr carcinoma combined with liver cirrhosis is empahasized.

Key words
hepatocellular carcinoma, multicentric carcinogenesis, quality of life

Reprint requests
Koji Okuda Second Department of Surgery, Kurume University School of Medicine
67 Asahi, Kurume, 830 JAPAN

Accepted
July 6, 1992

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