[Long-term postoperative courses of hepatocellular carcinoma with and without cirrhosis]

Until the end of August 1988, 158 patients with hepatocellular carcinoma underwent curative hepatic resection in our department. One-hundred and twenty-one patients (77%) had liver cirrhosis (Group A), and the remaining 37 (23%) did not (Group B). Background factors and postoperative courses were compared between Group A and Group B. With regard to clinical stage and curability, there were no significant differences between the two groups. On postoperative follow-up on 1- to 5-year survival, no differences were recognized between the two groups, but on and after 6-year survival, the former were significantly worse than the latter. The main cause of death was cancer in both groups. In group B, all intrahepatic recurrences happened within 3 years after surgery. On the other hand, intrahepatic recurrences of Group A were also found on postoperative 4- and 5-year to be as numerous as the recurrences found at 1-, 2- and 3-year after surgery. Moreover, with recurrent cases on and after 4 years in Group A, the frequency of solitary focus was high. The differences of postoperative courses between these two groups might be caused by metachronous carcinogenesis of cirrhotic liver.