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Related Experiment Videos

Surgery for small liver cancers

M Makuuchi1, T Kosuge, T Takayama

  • 1First Department of Surgery, Shinshu University, School of Medicine, Japan.

Seminars in Surgical Oncology
|July 1, 1993
PubMed
Summary
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Surgical resection of small hepatocellular carcinomas (HCCs) in 362 patients, including those with liver cirrhosis, demonstrated decreasing mortality and improved outcomes. Key prognostic factors for survival after hepatectomy were identified.

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Hepatocellular carcinoma (HCC) is a significant global health concern.
  • Surgical resection is a primary treatment for early-stage HCC.
  • Liver cirrhosis frequently coexists with HCC, complicating surgical management.

Purpose of the Study:

  • To evaluate the outcomes of surgical resection for small HCCs (≤5 cm) over 16 years.
  • To identify prognostic factors influencing survival after HCC resection.
  • To describe the surgical team's approach to patient selection and perioperative care.

Main Methods:

  • Retrospective analysis of 362 patients undergoing HCC resection (≤5 cm) from 1973-1989.
  • Inclusion of 266 patients with coexisting liver cirrhosis.

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  • Application of selective vascular occlusion and Pringle maneuver to minimize blood loss.

    • Main Results:

    • Operative and hospital mortality rates were 1.7% and 1.9%, respectively, with a decreasing trend over time.
    • 5-year survival rate was 43.7% in 1989, with 87% of patients discharged without blood transfusion.
    • Tumor size, number, intrahepatic metastasis, vascular invasion, capsular invasion, Edmondson grade, and operative procedure were significant prognostic factors.

    Conclusions:

    • Surgical resection of small HCCs is associated with acceptable mortality and survival rates.
    • Minimizing intraoperative blood loss through advanced techniques improves outcomes.
    • Tumor characteristics and operative factors are critical for predicting patient prognosis after hepatectomy.