Study on the Clinicopathological Characteristics and the Prognosis after Hepatic Resection of Hepatocellular Carcinoma with Simultaneously Multiple Nodules

Kazuo Hatsuse, Hideki Aoki, Michinori Murayama, Tsukasa Aihara, Nozomi Idota, Takuo Inui, Minoru Kakihara, Hidetaka Mochizuki, Shintaro Terahata*

First Department of Surgery, Clinical Laboratory*, National Defense Medical College

Sixty-seven patients underwent hepatic resection for hepatocellular carcinoma from 1985 to 1995. They were divided into 4 groups. The St group consisted of 41 patients with a solitary hepatocellular carcinoma; the BL group, of 12 patients with hepatocellular carcinoma, concomitant with early hepatocellular carcinoma of well-differentiated type or borderline lesions designated by the General Rules for the Clinical and Pathological Study of Primary Liver Cancer; the MO group, of 3 patients with multicentric occurrence; and the IM group, of 11 patients with intrahepatic metastases. Histopathological examination of the background liver revealed that the frequencies of liver cirrhosis in the BL group and the MO group were significantly higher than those in the IM group and the St group. Associated lesions were situated in the same segment in the IM group more frequently than in the BL and MO groups. Portal vein invasion was more marked in the IM group than in the other groups. Cumulative survival rates for the St group and the BL group were significantly better than for the IM group. But there were more recurrences within two years in the patients with invasion into the portal vein in the St group and the BL group. Cumulative 5-year disease-free survival rates of the St group were 45.8%. On the other hand all patients had recurred within 3 years in the BL group and within 2 years in the IM group. The above findings suggest that multicentric occurrence including borderline lesions tends to occur in patients with liver cirrhosis, and the prognosis after their resection is better than for intrahepatic metastasis, in spite of the high recurrence rates in the remnant liver.

Key words
liver cirrhosis, hepatocellular carcinoma, borderline lesions, multicentric occurrence, intrahepatic metastases

Reprint requests
Kazuo Hatsuse First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359, JAPAN

Accepted
September 9, 1997

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