PROGNOSTIC FACTORS OF HEPATOCELLULAR CARCINOMA AFTER CURATIVE HEPATIC RESECTION / 한국간담췌외과학회지

ABSTRACT

To further define the prognostic factors associated with long term survival of hepatocellular carcinoma, we retrospectively studied 371 patients with pathologically diagnosed hepatocellular carcinoma who underwent curative hepatic resection between 1991 and 1995. We included the 16 patients who underwent noncurative hepatic resection in calculating overall survival. The male to female ratio was 5.1 to 1 and their average age was 52.5 years. About 20 variables were subject to univariate and multivariate analysis and their survivals were calculated using the Kaplan-Meier method. 55.6% of (220 of 396) patients had liver cirrhosis and 73.2% of (290 of 396) patients were positive in HBsAg. Operative mortality and inhospital death rate were 1.5% and 0.8%, each and postoperative morbidity rate was 22.5%. The cumulative 1, 3 and 5 year survival rates including noncurative resected cases were 85.9%, 67.2% and 54.8%, respectively. The cumulative 1, 3 and 5 year survival rates of 371 curative resected cases were 87.3%, 68.7% and 56.4%, respectively. Disease free 1, 3, 5 year survival rates of 371 curative resected cases were 74.8%, 48.2% and 40.8%, respectively. The factors such as alpha- fetoprotein, Child's classification, prothrombin time, extent of liver resection, and number of tumor were statistically significant factors associated with cumulative survival.(p<0.05) And alpha-fetoprotein, total necrosis after TACE, viral hepatitis, and invasion of portal vein were significant factors associated with cumulative disease free survival. Only alpha-fetoprotein was associated significantly with cumulative survival and cumulative disease free survival. Length to the resection margin was not significantly associated with survival.