Tumor localization as a prognostic factor in hepatocellular carcinoma

We investigated the significance of tumor localization as a contributory factor in the prognosis of hepatocellular carcinoma. A trend toward a better survival rate was noted in the 57 patients whose tumors were confined to the left hepatic lobe [left lobe group] as compared with the 146 patients whose tumors were located strictly in the right hepatic lobe [right lobe group]. The difference in survival was significant (p < 0.02) in stage I and stage II disease, but equivalent survival rates were seen in stage III and stage IV disease. The right lobe group patients with stage I or stage II disease who underwent lobectomy or segmentectomy had a better survival rate than those undergoing subsegmentectomy or limited resection (p < 0.001). But in the left lobe group, no difference was observed with various operative procedures. These results lead us to speculate that tumor localization might be a contributory factor in the postoperative prognosis, and an important determinant of the operative approach to hepatocellular carcinoma.