Surgical Strategies and Tumor-free Survival in Large Hepatocellular Carcinoma

Taichi Shuto, Kazuhiro Hirohashi, Shoji Kubo, Hiromu Tanaka, Tadashi Tsukamoto, Takatsugu Yamamoto, ^*Takashi Ikebe, Kazuki Oba, Takahiro Uenishi and Hiroaki Kinoshita

Second Department of Surgery, Second Department of Pathology^*,
Osaka City University Medical School

Eighty-three patients with large hepatocellular carcinoma (>5cm), who underwent hepatic resections were analyzed for 30 clinicopathologic variables related to tumor-free survival after surgery. Univariate analysis showed that major hepatic resection (n=49), single nodular case (n=41), no portal invasion (n=75), no intrahepatic metastasis (n=36), complete surgical margin (n=36) and curative operation (n=25) were significant independent factors for longer tumor-free survival. Using multivariate analysis, only no intrahepatic metastasis on its own found to be an independent factor. Although 16 of 49 patients with major hepatic resection underwent percutaneous transhepatic portal embolization before surgery, it was not an independent prognostic factor in tumor-free survival. In order to have a long tumor-free survival for large HCCs, curative major hepatic resection with a complete surgical margin seemed to be necessary. Percutaneous transhepatic portal embolization may contribute to extension of surgical indications for large HCCs.

Key words
large hepatocellular carcinoma, major hepatic resection, tumor-free survival, percutaneous transhepatic portal empolization

Reprint requests
Taichi Shuto Second Department of Surgey, Osaka City University Medical School, 1-4-3 Aschi-machi Abeno-ku, Osaka, 545-8585 JAPAN

Accepted
May 25, 1999

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