Single Center Experience (Ten Years) with Surgical Resection for Treating Hepatocellular Carcinoma: Strategies for improving the long-term survival after resection
Korean Journal of Hepato-Biliary-Pancreatic Surgery
; : 245-253, 2008.
Article
de Ko
| WPRIM
| ID: wpr-98947
Bibliothèque responsable:
WPRO
ABSTRACT
PURPOSE: Although surgical resection is the most effective treatment for hepatocellular carcinoma (HCC), high recurrence after resection is a major challenging problem. We attempted to determine the optimal strategies for improving the long-term surgical outcome through the review of our 10 years' experience with surgically treating HCC. METHODS: We retrospectively reviewed 497 patients who received curative resection at the Yonsei University Health System from January 1996 to August 2006. RESULTS: The 5 year disease-free rate and the overall survival rate after curative resection were 45.0% and 63.9%, respectively. Of the 497 patients, 491 (98.8%) were Child-Pugh A and 107 (56.3%) were diagnosed with liver cirrhosis. The postoperative complication and mortality rates were 28.6% and 1.8%, respectively. Of the 243 recurrent patients, 184 (75.7%) were diagnosed with intrahepatic recurrence alone. Of these intrahepatic recurrent patients, 169 (91.9%) received active treatment, including transplantation (n=7), re-resection (n=12), local ablation therapy (n=18) and transarterial chemoembolization (n=132). Multivariate analysis revealed that perioperative transfusion, a satellite nodule, the pathologic TNM stage, the Edmondsons-Steiner grade, the serum alkaline phosphatase (ALP) and aspartate aminotransferase levels and cirrhosis were associated with disease free survival, and perioperative transfusion, a satellite nodule, macroscopic vascular invasion, the Edmondsons-Steiner grade, the ALP and serum albumin levels and the platelet count were related with overall survival after resection. CONCLUSIONS: The long-term surgical outcome of HCC can be further improved by proper patient selection, delicately performed surgery and administering postoperative adjuvant therapy for patients with a high risk of recurrence. Early diagnosis and aggressive treatment are needed to treat the recurrence
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Numération des plaquettes
/
Complications postopératoires
/
Aspartate aminotransferases
/
Récidive
/
Fibrose
/
Sérumalbumine
/
Analyse multifactorielle
/
Taux de survie
/
Études rétrospectives
/
Carcinome hépatocellulaire
Type d'étude:
Diagnostic_studies
/
Observational_studies
/
Screening_studies
Limites du sujet:
Humans
langue:
Ko
Texte intégral:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Année:
2008
Type:
Article