Postresection prognosis of patients with hepatocellular carcinoma

Between July 1973 and December 1990, 137 patients with hepatocellular carcinoma underwent potentially curative resection at our institution and were discharged from the hospital. The factors that contributed to long-term survival were studied by univariate and multivariate analyses.

The 5-year actuarial survival rate was 49%. Univariate analysis showed that smaller tumor, limited resection, wide margin, absence of tumor thrombus in the portal vein or intrahepatic metastases, and absence of tumor thrombus in the hepatic vein were favorable signs for long-term survival. Multivariate analysis revealed that wide margin and absence of tumor thrombus in the hepatic vein were significant factors. Currently, 26 patients have survived more than 5 years after operation. However, 20 (76.9%) of the 26 patients have had recurrence. The 5-year disease-free survival rate of the 137 patients is 19%. Most recurrences occurred within 3 years after operation and were observed in the remnant liver. Univariate analysis of contributory factors to disease-free survival showed that wide margin, absence of tumor thrombus in the portal vein or intrahepatic metastases, and absence of tumor thrombus in the hepatic vein were favorable signs. Multivariate analysis disclosed that wide margin and absence of tumor thrombus in the hepatic vein were significant factors.