Indications for hepatectomy for hepatocellular carcinoma — What stage of the disease is the best indication for surgery? |
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Authors: | Yo Sasaki Shingi Imaoka Hiroshi Nakano Osamu Ishikawa Hiroaki Ohigashi Takushi Yasuda Shoji Nakamori Masao Kameyama Masahiro Hiratsuka Toshiyuki Kabuto Hiroshi Furukawa Hiroshi Kasugai Atsuo Inoue Makoto Fujita and Etsuo Inoue |
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Institution: | (1) Departments of Surgery,,;(2) Gastrointestinal Medicine, and,;(3) Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537, Japan, JP |
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Abstract: | To determine the clinical and tumor stage of hepatocellular carcinoma (HCC) that is the best indication for surgery, the
postoperative long-term outcomes of patients who underwent hepatic resection were examined retrospectively. Of 975 patients
with HCC who underwent regional therapy, 384 patients (39%) received hepatic resection (HR), 534 (55%) had transcatheter arterial
chemoembolization (TACE), and the remaining 57 (6%) received percutaneous ethanol injection (PEI) into the tumor. The criteria
defined by liver Cancer Study Group of Japan was used for staging and liver functional reserve (i.e., clinical staging).1 In the 133 patients with stage I HCC, there were no significant differences among the survivals of the HR, TACE, and PEI
groups. In the 314 patients with stage II HCC, the 5- and 7-year survival rates were 51% and 46% in the HR group, 23% and
10% in the TACE group, and 0% and 0% in the PEI group. The survival of the HR group was significantly better than the survivals
of the TACE and PEI groups (P < 0.001). The 5- and 10-year survivals of the stage II HCC patients who had HR were 64% and 47% in the clinical stage I (i.e.,
good liver function) group, significantly better than the 5; and 10-year survivals (32% and 23%) in the clinical stage II
(i.e., bad liver function) group (P < 0.0001). Patients with good liver function in stage II are expected to have better survival and are considered to be the
most suitable for HR.
Received for publication on June 9, 1997; accepted on July 3, 1997 |
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Keywords: | : indications for hepatectomy for hepatocellular carcinoma hepatic resection TAE PEI |
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