Analysis of the Relationship between Extent of Hepatic Resection and Postoperative Prognosis for Samll Solitary Hepatocellular Carcinoma

Yasuo Matsuda, Toshikazu Ito, Yuji Seo, Shinichi Hatsuoka, Nobuko Ito, Keiji Iwata, Masahiro Hujikawa, Yoshiro Oguchi, Yasuharu Nomura*, Iwao Yabuchi*

Department of Surgery and Department of Internal Medicine*, Otemae Hospital

In the present study we investigated the influence of the extent of hepatic resection on postoperative prognosis for solitary hepatocellular carcinoma (HCC) smaller than 2 cm in diameter. Forty two patients with small primary HCC underwent curative hepatic resection without any operative deaths. Twentyeight of these 42 patients underwent minor hepatic resection limited to subsegmentectomy, and the remaining 14 patients underwent major hepatic resection more extensive than segmentectomy. Background and postoperative prognosis were compared between these two groups. There were no statistically significant difference between the two groups in background factors including reserve of liver function, stage of disease and various factors related to the operative procedure. There was no statistically significant difference in the incidence of postoperative complications between the two groups. The survival rates at 3 and 5 years in the group with minor hepatic resection were 88% and 54%, respectively. They were 100% and 75%, respectively, in the other group. The survival rate of the latter group tended to be better than that of the former group. However, the difference did not reach statistical significance. The rate of recurrence was not significantly different between the two groups. In conclusion, if limited hepatic resection is expected to be sufficiently curative, it should be considered for small solitary HCC in the early stage.

Key words
small hepatocellular carcinoma, extent of hepatectomy, prognosis

Reprint requests
Yasuo Matsuda Department of Surgery, Otemae Hospital
1-5-34 Otemae, Chuuo-ku, Osaka, 540 JAPAN

Accepted
November 9, 1994

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