[Surgical treatment of 1450 patients with hepatocellular carcinoma]

An analysis of 1450 patients with pathologically and surgically proved hepatocellular carcinoma (HCC) revealed a steadily increased 5-year survival rate of 2.8% (1958-1968), 10.5% (1969-1979), and 36.6% (1980-1990), owing to increased number of cases with small HCC (0.9%, 9.9%, 25.2%, respectively), more and more patients undergoing tumor resection (0, 14, 59) and preoperative tumor bulk reduction for otherwise unresectable HCC (0, 1, 33 cases). Small HCC resection (n = 250) resulted in a high 5-year survival rate as compared to non-small HCC resection (n = 491) (66.3% versus 31.2%). The 5-year survival of 73 patients undergoing tumor re-resection was 40.6%, and the 5-year survival of 34 patients having second stage resection was as high as that of those having small HCC resection (62.0%). 125 patients survived more than 5 years; of these 65 underwent small HCC resection, and 43 non-small HCC resection. Thus, early resection, re-resection for subclinical recurrence, and second stage resection for originally unresectable HCC play an important role in improving prognosis of HCC.