A Clinical Investigation into the Factors Influencing the Prognosis of Patients with Primary Liver Cancer after Hepatectomy

Objective To explore the factors influencing the prognosis of patients with primary liver cancer(PLC) after hepatectomy on purpose to provide the preventive measures for improving the long-term effect.Methods All of the 189 patients who underwent hepatectomy with PLC from May,1994 to January,1998 were included by reviewing their clinical pathological characteristics and treatments. Totally, 22 factors contributed to the long-term survival rate(SR)and the disease-free SR were analysed . All patients were followed up at least 5 years. Results The 3- and 5-year cumulative SRs in the total group were 63% and 45% respectively. The 3- and 5-year SRs and disease-free SRs in the curative resection (CR) group (n=162) were 67%,47%,and 45% and 26% respectively. It was showed that the way by which a tumor was found, tumor size, portal thrombi, satellite nodule, cirrhosis type, TNM stage, tumor envelope, recurrence and treatment, vascular exclusion and transfusion, differentiation grade and CR were prognostic factors by individual variable analysis. A multivariable analysis showed that CR , tumor size and reoperation were significant factors associated with the prognosis. Conclusion The type of CR and tumor size are determinants influencing the prognosis. Early diagnosis of small carcinoma and CR as soon as possible is essential to improving the prognosis of PLC. Avoiding transfusion and controlling the progress of cirrhosis are expected to improve the disease-free SR.