Major compared with limited hepatic resection for hepatocellular carcinomawithout underlying cirrhosis: A retrospective analysis

Objective: To find out if patients with hepatocellular carcinoma (HCC) with no underlying cirrhosis benefit from major hepatic resection. Design: Retrospective study. Setting: University hospital, Japan. Patients: 58 patients without cirrhosis and with HCC 10 cm in diameter or l ess. Interventions: 25 had major and 33 had limited hepatic resections. Main outcome measures: Overall and disease-free survival, and prognostic fa ctors verified by univariate and multivariate analyses. Results: 6 patients developed major complications (10%), two of whom died w ithin 60 days of operation. There were no differences in postoperative morb idity and mortality between the two groups. The overall and disease-free su rvival were similar as was the incidence and pattern of intrahepatic tumour recurrence. Hepatitis B surface (HBs) antigen (positive), tumour size (sma ller than 3 cm), and surgical margin (clear) were favourable indicators of disease-free survival on multivariate analysis. Conclusions: Major hepatic resection should not necessarily be done for HCC without cirrhosis but it is important to take an adequate surgical margin. Overall and disease-free survival are better in patients who are HBs-antig en positive than those who are negative because most of the latter an posit ive for hepatitis C virus.