Related Experiment Videos
Major compared with limited hepatic resection for hepatocellular carcinoma without underlying cirrhosis: a
N Nagasue1, A Yamanoi, O N el-Assal
1Department of Surgery, Shimane Medical University, Izumo, Japan.
Objective:
To find out if patients with hepatocellular carcinoma (HCC) with no underlying cirrhosis benefit from major hepatic resection.
Design:
Retrospective study.
Setting:
University hospital, Japan.
Patients:
58 patients without cirrhosis and with HCC 10 cm in diameter or less.
Interventions:
25 had major and 33 had limited hepatic resections.
Main Outcome Measures:
Overall and disease-free survival, and prognostic factors verified by univariate and multivariate analyses.
Results:
6 patients developed major complications (10%), two of whom died within 60 days of operation. There were no differences in postoperative morbidity and mortality between the two groups. The overall and disease-free survival were similar as was the incidence and pattern of intrahepatic tumour recurrence. Hepatitis B surface (HBs) antigen (positive), tumour size (smaller than 3 cm), and surgical margin (clear) were favourable indicators of disease-free survival on multivariate analysis.
Conclusions:
Major hepatic resection should not necessarily be done for HCC without cirrhosis but it is important to take an adequate surgical margin. Overall and disease-free survival are better in patients who are HBs-antigen positive than those who are negative because most of the latter are positive for hepatitis C virus.