The Changes of Clinical Pattern of Patients Who Underwent Hepatectomies for Hepatocellular Carcinoma according to Chronological Periods

ABSTRACT

PURPOSE: The purpose of this study was to identify changes over several years in clinical patterns of patients who underwent hepatectomies for HCC. METHODS: There were 502 patients who underwent hepatectomies for HCC between January 1986 and July 2009 at the Korea Cancer Center Hospital, Seoul, Korea. Period 1 (n=206) extended from the beginning to December 2000. Period 2 from January 2001 to December 2004 (n=146). Period 3 from January 2005 to July 2009 (n=150). The data for the different periods were compared retrospectively or prospectively. RESULTS: Compared to patients from Period 1, Period 2 and Period 3 patients had operations >6 months from diagnosis (p=0.002), high levels of preoperative AST and ALT (p<0.001), and poor scores on the ICG R15 test (p=0.047). The Frequency of Transfusion during the operation was decreased (p<0.001), but there was no difference in postoperative complication rates (p=0.403). In Periods 2 and 3, there was a higher frequency of multiple tumors (p<0.001) and microvascular invasions histologically (p<0.001). Differences between periods in disease free survival rates were not significant. CONCLUSION: The reason for the higher frequency, in more recent periods, of patients presenting at surgery with advanced HCC stages is the longer interval between diagnosis and operative time, and an increase in the number of non-surgical treatments before surgery. Because of differences in follow-up intervals, it was difficult to evaluate the influence of period on survival rates. Hence, a longer follow-up period will be required for an accurate evaluation of changes in survival with time.