Clinicopathologic Features and Surgical Indication for Early Hepatocellular Carcinoma

Taichi Shuto, Kazuhiro Hirohashi, Takatsugu Yamamoto, Takahiro Uenishi, Shogo Tanaka, Masao Ogawa, Shigekazu Takemura, Hiromu Tanaka, Shoji Kubo and Hiroaki Kinoshita

Department of Gastrointestinal & Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine

Purpose: We clarified the clinicopathologic features and surgical strategies for early hepatocellular carcinoma (HCC), analyzing resected small HCCs. Methods: Of 82 patients with resected HCC less than 2 cm in diameter in the last 10 years, 20 were defined as early HCC, and the remaining 62 as non early HCC. We compared clinicopathologic features between groups. In early HCC, we also studied postoperative prognostic factors for tumor-free survival (TFS). Results: No significance was seen in preoperative liver functional tests and histological findings for the noncancerous hepatic parenchyma. Portal invasion and HBsAg were not detected in early HCC. The average of resected tumor diameter was 1.5 cm in early HCC and 1.7 cm in non early HCC (p<0.1). Multicentric occurrence numbered 5 (82%) in early HCC, and 6 (29%) in non early HCC (p<0.05). Postoperative TFS at 1 year in early HCC was 100% and 57% at 5 years, and 82% at 1 year in non early HCC and 22% at 5 year (p<0.05). NO significance was seen in survival after surgery between groups, and 67% of death was caused by cancer in both groups. In early HCC, 2 variables found to be independent postoperative prognostic factors were higher albuminemia and curative hepatic resection. Conclusions: Early HCC tumors were smaller and multicentric occurrence was more often seen. Portal invasion and HBsAg were not detected in early HCC. Postoperative TFS in early HCC was better, but the course after recurrence was same as in non early HCC. To ensure better survival in early HCC, we suggest curative resection for each nodular lesions.

Key words
early hepatocellular carcinoma, hepatric resection, clinicopathologic features of hepatocellular carcinoma, surgical indication of hepatocellular carcinoma

Reprint requests
Taichi Shuto Department of Gastrointestinal Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585 JAPAN

Accepted
January 30, 2002

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