Management of hepatocellular carcinoma: long-term outcome in 2639 cases

This paper reports the progress of management in 2639 patients with pathologically proven primary liver cancer (PLC) over the past three decades, and the factors improving long-term outcome. The 5-, and 10-year survival after resection of PLC was 45.9% and 34.8%, respectively, for the whole series (n = 1826), and 61.3% and 45.7%, respectively, for patients with small PLC (< = 5 cm, n = 645). The 5-year survival after cryosurgery was 37.9% for the whole series (n = 191), and 53.1% for patients with small PLC (n = 56). The 5-year survival of 73 patients receiving sequential resection after cytoreduction therapy was 67.8%. The 5-year survival after re-resection for recurrence tumor (n = 148) was 34.5%; 239 patients survived more than 5 years; 124 of these patients (51.9%) were small PLC, and 63 patients survived more than 10 years. Encouraging changes in the prognostic pattern were observed when the PLC data of 1958-1970 (n = 178), 1971-1982 (n = 582) and 1983-1994 (n = 1879) were compared; the 5-year survival being 4.8%, 11.2% and 45.4%, respectively, and the 10-year survival being 4.2%, 7.5% and 34.6%, respectively. Some aspects to prolong survival further were discussed.