CONSERVATIVE HEPATIC RESECTION FOR HEPATOCELLULAR-CARCINOMA OF CIRRHOTIC-PATIENTS

We evaluated in retrospect the applicability of conservative hepatic r esection for hepatocellular carcinoma (HCC) of cirrhotic patients, Eig hty (14.6%) of 548 patients with HCC underwent liver resection over a period of 10 years in this hospital, They were divided into two groups according to surgical procedures, In group I, 22 patients underwent m ajor hepatic resection, and in group II, 58 patients underwent conserv ative liver resection, The operative mortality for patients in group I was 13.6% while it was 3.5% for those in group II, The difference was significant (p<0.05). The five-year survival rate was 22% for patient s in group I, while it was 21% for group II patients, The rate of HCC recurrence was 47.4% for group I patients while it was 57.1% for group II patients. The difference was not significant. The tumor-free survi val rates at 6-, 12-, 24- and 36-months were 80%, 75%, 55% and 55% res pectively for patients in group I, while they were 50%, 42.5%, 42.5% a nd 42.5% for patients in group II. It suggested that conservative live r resection was associated with early recurrence of HCC. But the diffe rence of mean tumor-free survival time is not significant (35.82+/-5.4 7 vs 38.63+/-8.05 months, p>0.05). Using Cox's regression analysis, th e presence of Child's B was identified as an independent adverse progn ostic factor (p=0.000) for long-term survival, The factors associated with poor tumor-free survival rate were Child's classification (p=0.00 8), metastasis (p=0.021), liver cirrhosis (p=0.039) and tumor size (p= 0.054). By evaluating the operative mortality, long-term survival rate , prognostic factors for cumulative survival time and tumor-free survi val time, it suggests that conservative liver resection can be selecti vely used to treat HCC associated with liver cirrhosis.