Surgical treatment of hepatocellular carcinoma:a report of 408 cases / 中国普通外科杂志

ABSTRACT

Objective To investigate the effect of surgical treatment and the influence factors of treatment effect in patieats with hepatocellular carcinoma (HCC). Methods The clinical materials of 408 cases of HCC who underwent surgical intervention in recent 8 years were retrospectively analyzed. Results The 408 patients accounted for 43.9% of patients with HCC admitted during the same time. Of the 408 patients, large HCC accounted for 81.9% of patients, 8.5% of cases complicated by portal vein thrombus (PVT) ,and 4.8% of cases complicated by bile duct thrombus (BDT). In this series, 118 cases received left external lobectomy, 97 cases received left hemihepatectomy, 112 cases received right hemihepatectomy, 73 cases received right segmentectomy , 8 cases received left and righ segmentectomy ,35 cases received hepatectomy combining with removal of PVT , 20 cases received hepatectomy combined with thrombectomy of BDT; 48 cases received hepatectomy combined with implanment of drug delivery system (DDS) (35 patients with portal vein thrombus received DDS through portal vein). Three hundred and two cases had postoperative complications, including subdiaphragm abscesses,lung infection. upper digestive tract bleeding,pleural effusion ,ascites,wound spliting etc. Mortalily was 2.7%; cancer residual rate was 18.4%;postoperative recurrence and/or metastasis was 73.0%.The 1,3and 5-year survival rate was 73.9%,51.3%, 35.5 % respectively. Conclusions This results show that most of the patients with HCC received surgical operation treatment are in advanced stage, postoperative recurrence and/or metastasis are the main influence factors of treatment effect.