[Criteria of curability in the resection therapy for hepatocellular carcinoma]

The present study was aimed at determining a criteria for curability of hepatic resection in the treatment of hepatocellular carcinomas. The 239 patients hepatectomized from 1973 through 1987 were included for analysis. The patients with the tumor thrombi(V) or intrahepatic metastasis(IM) scattered over the unilateral lobe(IM2) showed very poor prognosis in spite of macroscopically complete resections. Consequently, these conditions were categorized into non-curative group(NC). The 5-year survival rate of the tumors less than 2 cm was 42%, which was much better than that of 5 cm or more group but no better than that of 2 to 5 cm group. When the prognosis was compared by an extent of resection among the patients with the tumors of less than 5 cm in size and V(-), the patients with lobectomy showed a 5-year survival rate of 84%, much better than 45% of those with segmentectomy or less range. The surgical margin (SM) negative patients showed a better prognosis than the SM positive patients with a slight difference. The tumor backgrounds of the 39 patients who survived three years with disease free condition were as follows: V(-) in all, no intrahepatic metastasis(IM0) in 79%, no IM2, massive resection for all IM1 in whom IM was confined to the area close to the main tumors, a tumor size of 5 cm or less in 82%, SM(-) in 62%. From the findings described above, we defined a complete resection for V(-) and IM0-1 as a curative condition, of which absolute curative resections(AC) corresponded to the patients with the tumors of 5 cm or less and SM(-), and relative curative ones(RC) to the remainders.(ABSTRACT TRUNCATED AT 250 WORDS)