Outcome following hepatectomy for HBs Ag positive Hepatocellular Carcinoma Patients / 한국간담췌외과학회지

ABSTRACT

BACKGROUND/AIMS: In Korea about 70% of hepatocellular carcinoma(HCC) are associated with hepatitis B surface antigenemia. And hepatic resection is regarded as best treatment option for selected HCC patients. So we conducted this study to analyze the outcome and to identify the factors associated with outcome after hepatectomy for HBs Ag associated HCC. METHODS: We retrospectively analyzed the clinicopathological data of 104 HBs Ag associated HCC patients who underwent hepatic resection from Sep-1987 through Oct-1997 in KCCH. Median follow-up period was 21.5 month. Survival rates were estimated by Kaplan-Meier method and difference was detected by Log-rank test using SPSS program for Windows. Multivariate analysis was done using Cox regression hazard model. RESULTS: Overall 5 year survival rate was 62.9% and 5 year disease free survival rate was 42.2%. Factors which influence on survival were multiplicity, portal vein invasion, perioperative transfusion, tumor stage. Recurrence occurred in 42 cases and 33 cases developed intrahepatic recurrence. 3 year survival rate after recurrence was 34.7%. CONCLUSION: Hepatic resection plays a significant role for selected HBs Ag related HCC and tumor number, portal vein invasion, transfusion and TNM stage were statistically significant prognostic factors( p<0.05). So meticulous technique is required to avoid transfusion perioperatively. For the high risk patients, further study to reduce the recurrence should be followed.