LONG-TERM RESULTS OF SURGERY FOR SMALL PRIMARY LIVER-CANCER IN 514 ADULTS

During 1958-1993, 2030 patients with pathologically proven primary liv er cancer (PLC) were retrospectively reviewed. Comparison between smal l PLC (less than or equal to 5 cm, n = 514) and large PLC (> 5 cm, n = 1516) revealed that small PLC had a higher resection rate (92.4% vers us 49.1%), lower operative mortality (1.7% versus 5.2%), a higher perc entage of single tumour nodules (78.0% versus 53.4%), a higher percent age of well encapsulated tumour (74.5% versus 35.8%) and higher surviv al rates after resection (5-year, 63.8% versus 36.6%; 10-year, 46.8% v ersus 28.5%). No significant difference was found between survival fol lowing limited resection (n = 440) and lobectomy (n = 34) in patients with small PLC. Re-resection of any subclinical recurrence or solitary pulmonary metastasis after small PLC resection was done in 70 cases. These results indicate that resection is still the modality of choice for treatment of small PLC; limited resection instead of lobectomy was the key to increasing resectability and decreasing operative mortalit y; re-resection of subclinical recurrence was important to prolong sur vival further.