Experience in one thousand hepatectomy for small hepatocellular carcinoma.
Abstract：Objective To summarize the experience in surgery for small hepatocellular carcinoma(HCC) and the factors influencing or improving long -term survival. Methods Comparison clinicopathological data between small HCC and large HCC. A Cox proportional hazards modal was used for multivariate analysis of prognostic factors. Results Comparison between small HCC ( n ＝ 1000) and large HCC ( n ＝ 1366) revealed that small HCC had a higher resection rate (93.6%, 1000/1068 versus 55.7%, 1366/2451, P ＜0.01),a lower operative mortality (1.5%, 15/1000 versus 3.7% ,50/1366, P ＜0.01), a better differentiation of cancer cells(Edmondson' s grade Ⅲ～Ⅳ, 14.9% versus 20.1%, P＜0.01 ),a higher incidence of single- nodule tumor(82.6% versus 64.4%, P＜0.01 ),a higher proprotion of well encapsulate tumor(73.3 % versus 46.3%, P ＜0.01 ), less tumor emboli in the portal vein(4.9% versus 20.8%, P＜0.01), and higher survival rates after resection(5 year, 62.7% versus 37.1%, P＜0.01; 10 year, 46.3% versus 29.2%, P＜0.01 ). No significant difference was found between survival following minor resection(n=949) and lobectomy( n＝ 51 ) in patients with small HCC( P＞0.05 ).Re-resection of subclinical recurrence or solitary pulmonary metastasis after small HCC resection was done in 84 cases. Conclusion Resection is still the modality of first choice for treatment of small HCC, minor resection instead of lobectomy was the key to increasing resectability and decreasing operative mortality, re - resection for subclinical recurrence or solitary pulmonary metastasis was important approach to prolong survival further.
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Publication Date：2001-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 41-44 )