Significance of TNM classification in prognostic evaluation of hepatocellular carcinoma following hepatectomy

Objective: To analyze correlation between TNM classification of hepatocellular carcinoma (HCC) and disease-free survival in order to evaluate its significance in predicting the long-term result after hepatctomy. Methods: A retrospective survey was carried out in 1,725 cases with HCC patients performed hepatectomy from January 1990 to December 1995. The follow-up rate was 84.5%. The prognostic factors were analyzed by Cox proportional hazards survival model and disease-free survival was calculated by Kaplan-Meier estimation. Results: Univariate analysis showed thirteen clinicopathological prognostic factors including TNM staging. Multivariate analysis revealed four significant predictors such as preoperative lesion number, tumor size, daughter nodules and vascular invasion, which were encompassed in TNM classification. The 5-year disease-free survival rate were 24.6% of stage I, 38.4% of stage II, 15.9% of stage III, and 5.3% of stage IVa respectively. There was no significant difference in disease-free survival between stages I and II. Conclusion: TNM staging is one of the most significant prognostic factors in predicting disease-free survival of HCC patient after hepatectomy, but some items need modifying.