Skip to main content
Top
Published in: World Journal of Surgery 3/2006

01-03-2006

Factors Associated with Disease Survival after Surgical Resection in Chinese Patients with Hepatocellular Carcinoma

Authors: Li Qiang, Li Huikai, Kelly Butt, P. Peter Wang, Xishan Hao

Published in: World Journal of Surgery | Issue 3/2006

Login to get access

Abstract

Objective

The aim of this cohort study was to investigate clinical outcome and prognostic factors after surgical resection for hepatocellular carcinoma (HCC).

Materials and Methods

A total of 1,157 HCC patients undergoing hepatic resection between 1998 and 2003 were included in this study. Univariate and multivariate analyses were performed to examine factors affecting clinical outcome and recurrence.

Results

Surgical procedures consisted of 1,011 (87.4%) anatomical resections, including 205 (17.7%) extended hepatectomies, 324 (28.0%) hemihepatectomies, 482 (41.7%) segmental resections, and 146 (12.6%) local resections. The results suggest that 56.6% of patients had a recurrence of HCC during the study period and the main recurrence type was intrahepatic (542; 83.1%). The median survival time was 45 months. The 1-, 3- and 5-year overall disease-free survival rates for the study population were 74%, 47%, and 39% respectively.

Conclusions

The results of proportional hazard analyses suggest that tumor size, number of nodules and vascular invasion were significant predictors for poor survival rates.
Literature
1.
go back to reference Howe HL, Wingo PA, Thun MJ, et al. Annual report to the nation on the status of cancer (1973 through 1998), featuring cancers with recent increasing trends. J Natl Cancer Inst 2001;93:824–842CrossRefPubMed Howe HL, Wingo PA, Thun MJ, et al. Annual report to the nation on the status of cancer (1973 through 1998), featuring cancers with recent increasing trends. J Natl Cancer Inst 2001;93:824–842CrossRefPubMed
2.
go back to reference Hao XS, Wang PP, Chen KX, et al. Twenty-year trends of primary liver cancer incidence rates in an urban Chinese population. Eur J Cancer Prev 2003;12(4):273–279CrossRefPubMed Hao XS, Wang PP, Chen KX, et al. Twenty-year trends of primary liver cancer incidence rates in an urban Chinese population. Eur J Cancer Prev 2003;12(4):273–279CrossRefPubMed
3.
go back to reference Kaczynski J, Hansson G, Wallerstedt S. Incidence of primary liver cancer and aetiological aspects: a study of a defined population from a low-endemicity area. Br J Cancer 1996;73:128–132PubMed Kaczynski J, Hansson G, Wallerstedt S. Incidence of primary liver cancer and aetiological aspects: a study of a defined population from a low-endemicity area. Br J Cancer 1996;73:128–132PubMed
4.
go back to reference Hao XS, Chen KX, Wang PP, Rohan T. Changes in survival patterns in urban Chinese patients with liver cancer. World J Gastroenterol 2003;9(6):1212–1215PubMed Hao XS, Chen KX, Wang PP, Rohan T. Changes in survival patterns in urban Chinese patients with liver cancer. World J Gastroenterol 2003;9(6):1212–1215PubMed
5.
go back to reference Tang ZY, Ye SL, Liu YK, et al. A decade’s studies on metastasis of hepatocellular carcinoma. J Cancer Res Clin Oncol 2004;130(4):187–196CrossRefPubMed Tang ZY, Ye SL, Liu YK, et al. A decade’s studies on metastasis of hepatocellular carcinoma. J Cancer Res Clin Oncol 2004;130(4):187–196CrossRefPubMed
6.
go back to reference Makuuchi M, Takayama T, Kubota K, et al. Hepatic resection for hepatocellular carcinoma—Japanese experience. Hepatogastroenterology 1998;45(3):1267–1274PubMed Makuuchi M, Takayama T, Kubota K, et al. Hepatic resection for hepatocellular carcinoma—Japanese experience. Hepatogastroenterology 1998;45(3):1267–1274PubMed
7.
go back to reference Yamanaka N, Okamoto E, Toyosaka A, et al. Prognostic factors after hepatectomy for hepatocellular carcinomas. A univariate and multivariate analysis. Cancer 1990;65:1104–1110PubMed Yamanaka N, Okamoto E, Toyosaka A, et al. Prognostic factors after hepatectomy for hepatocellular carcinomas. A univariate and multivariate analysis. Cancer 1990;65:1104–1110PubMed
8.
go back to reference Balsells J, Charco R, Lazaro JL, et al. Resection of hepatocellular carcinoma in patients with cirrhosis. Br J Surg 1996;83:758–761PubMed Balsells J, Charco R, Lazaro JL, et al. Resection of hepatocellular carcinoma in patients with cirrhosis. Br J Surg 1996;83:758–761PubMed
9.
go back to reference Vauthey JN, Klimstra D, Franceschi D, Tao Y, Fortner J, Blumgart L, et al. Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma. Am J Surg 1995;169:28–34; discussion 34–35CrossRefPubMed Vauthey JN, Klimstra D, Franceschi D, Tao Y, Fortner J, Blumgart L, et al. Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma. Am J Surg 1995;169:28–34; discussion 34–35CrossRefPubMed
10.
go back to reference Franco D, Capussotti L, Smadja C, et al. Resection of hepatocellular carcinomas. Results in 72 European patients with cirrhosis. Gastroenterology 1990;98:733–738PubMed Franco D, Capussotti L, Smadja C, et al. Resection of hepatocellular carcinomas. Results in 72 European patients with cirrhosis. Gastroenterology 1990;98:733–738PubMed
11.
go back to reference Greene FL, Page DL, Fleming ED, et al. (eds) AJCC Cancer Staging Manual, 6th edn. Springer, Berlin Heidelberg New York, 2002. pp 131–144 Greene FL, Page DL, Fleming ED, et al. (eds) AJCC Cancer Staging Manual, 6th edn. Springer, Berlin Heidelberg New York, 2002. pp 131–144
12.
go back to reference Sakon M, Umeshita K, Nagano H, et al. Clinical significance of hepatic resection in hepatocellular carcinoma: analysis by disease-free survival curves. Arch Surg 2000;135(12):1456–1459PubMed Sakon M, Umeshita K, Nagano H, et al. Clinical significance of hepatic resection in hepatocellular carcinoma: analysis by disease-free survival curves. Arch Surg 2000;135(12):1456–1459PubMed
13.
go back to reference Fan ST, Lo CM, Liu CL, et al. Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg 1999;229:322–330CrossRefPubMed Fan ST, Lo CM, Liu CL, et al. Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg 1999;229:322–330CrossRefPubMed
14.
go back to reference Miyagawa S, Makuuchi M, Kawasaki S, et al. Criteria for safe hepatic resection. Am J Surg 1995;169:589–594CrossRefPubMed Miyagawa S, Makuuchi M, Kawasaki S, et al. Criteria for safe hepatic resection. Am J Surg 1995;169:589–594CrossRefPubMed
15.
go back to reference Shimada M, Takenaka K, Fujiwara Y, et al. Risk factors linked to postoperative morbidity in patients with hepatocellular carcinoma. Br J Surg 1998;85:195–198CrossRefPubMed Shimada M, Takenaka K, Fujiwara Y, et al. Risk factors linked to postoperative morbidity in patients with hepatocellular carcinoma. Br J Surg 1998;85:195–198CrossRefPubMed
16.
go back to reference Imamura H, Seyama Y, Kokudo N, et al. One thousand fifty-six hepatectomies without mortality in 8 years. Arch Surg 2003;138(11):1198–1206; discussion 1206PubMed Imamura H, Seyama Y, Kokudo N, et al. One thousand fifty-six hepatectomies without mortality in 8 years. Arch Surg 2003;138(11):1198–1206; discussion 1206PubMed
17.
go back to reference Pugh RNH, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646–649PubMed Pugh RNH, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646–649PubMed
18.
go back to reference Fan ST, Lo CM, Liu CL, et al. Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg 1999;229:322–330CrossRefPubMed Fan ST, Lo CM, Liu CL, et al. Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg 1999;229:322–330CrossRefPubMed
19.
go back to reference Ziparo V, Balducci G, Lucandri G, et al. Indications and results of resection for hepatocellular carcinoma. Eur J Surg Oncol 2002;28(7):723–728CrossRefPubMed Ziparo V, Balducci G, Lucandri G, et al. Indications and results of resection for hepatocellular carcinoma. Eur J Surg Oncol 2002;28(7):723–728CrossRefPubMed
20.
go back to reference Okada S, Shimada K, Yamamoto J, et al. Predictive factors for postoperative recurrence of hepatocellular carcinoma. Gastroenterology 1994;106:1618–1624PubMed Okada S, Shimada K, Yamamoto J, et al. Predictive factors for postoperative recurrence of hepatocellular carcinoma. Gastroenterology 1994;106:1618–1624PubMed
21.
go back to reference Jwo SC, Chiu JH, Chau GY, et al. Risk factors linked to tumor recurrence of human hepatocellular carcinoma after hepatic resection. Hepatology 1992;16:1367–1371PubMed Jwo SC, Chiu JH, Chau GY, et al. Risk factors linked to tumor recurrence of human hepatocellular carcinoma after hepatic resection. Hepatology 1992;16:1367–1371PubMed
22.
go back to reference Nagasue N, Uchida M, Makino Y, et al. Incidence and factors associated with intrahepatic recurrence following resection of hepatocellular carcinoma. Gastroenterology 1993;105:488–494PubMed Nagasue N, Uchida M, Makino Y, et al. Incidence and factors associated with intrahepatic recurrence following resection of hepatocellular carcinoma. Gastroenterology 1993;105:488–494PubMed
23.
go back to reference Bismuth H, Chiche L, Castaing D. Surgical treatment of hepatocellular carcinomas in non-cirrhotic liver: experience with 68 liver resections. World J Surg 1995;19:35–41PubMed Bismuth H, Chiche L, Castaing D. Surgical treatment of hepatocellular carcinomas in non-cirrhotic liver: experience with 68 liver resections. World J Surg 1995;19:35–41PubMed
24.
go back to reference Ikeda K, Saitoh S, Tsubota A, et al. Risk factors for tumor recurrence and prognosis after curative resection of hepatocellular carcinoma. Cancer 1993;71:19–25PubMed Ikeda K, Saitoh S, Tsubota A, et al. Risk factors for tumor recurrence and prognosis after curative resection of hepatocellular carcinoma. Cancer 1993;71:19–25PubMed
25.
go back to reference Hu RH, Lee PH, Yu SC, et al. Surgical resection for recurrent hepatocellular carcinoma: prognosis and analysis of risk factors. Surgery 1996;120:23–29PubMed Hu RH, Lee PH, Yu SC, et al. Surgical resection for recurrent hepatocellular carcinoma: prognosis and analysis of risk factors. Surgery 1996;120:23–29PubMed
26.
go back to reference Kawasaki S, Makuuchi M, Miyagawa S, et al. Results of hepatic resection for hepatocellular carcinoma. World J Surg 1995;19:31–4CrossRefPubMed Kawasaki S, Makuuchi M, Miyagawa S, et al. Results of hepatic resection for hepatocellular carcinoma. World J Surg 1995;19:31–4CrossRefPubMed
27.
go back to reference Vauthey JN, Klimstra D, Franceschi D, et al. Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma. Am J Surg 1995;169:28–34; discussion 34–35CrossRefPubMed Vauthey JN, Klimstra D, Franceschi D, et al. Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma. Am J Surg 1995;169:28–34; discussion 34–35CrossRefPubMed
28.
go back to reference Shimada M, Matsumata T, Taketomi A, et al. Repeat hepatectomy for recurrent hepatocellular carcinoma. Surgery 1994;115:703–706PubMed Shimada M, Matsumata T, Taketomi A, et al. Repeat hepatectomy for recurrent hepatocellular carcinoma. Surgery 1994;115:703–706PubMed
29.
go back to reference Yamamoto J, Kosuge T, Takayama T, et al. Recurrence of hepatocellular carcinoma after surgery. Br J Surg 1996;83:1219–1222CrossRefPubMed Yamamoto J, Kosuge T, Takayama T, et al. Recurrence of hepatocellular carcinoma after surgery. Br J Surg 1996;83:1219–1222CrossRefPubMed
30.
go back to reference Fuster J, Garcia-Valdecasas JC, Grande L, et al. Hepatocellular carcinoma and cirrhosis. Results of surgical treatment in a European series. Ann Surg 1996;223:297–302CrossRefPubMed Fuster J, Garcia-Valdecasas JC, Grande L, et al. Hepatocellular carcinoma and cirrhosis. Results of surgical treatment in a European series. Ann Surg 1996;223:297–302CrossRefPubMed
31.
go back to reference Nagasue N, Kohno H, Chang YC, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg 1993;217:375–384PubMed Nagasue N, Kohno H, Chang YC, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg 1993;217:375–384PubMed
32.
go back to reference Sasaki Y, Imaoka S, Masutani S, et al. Influence of coexisting cirrhosis on long-term prognosis after surgery in patients with hepatocellular carcinoma. Surgery 1992;112:515–521PubMed Sasaki Y, Imaoka S, Masutani S, et al. Influence of coexisting cirrhosis on long-term prognosis after surgery in patients with hepatocellular carcinoma. Surgery 1992;112:515–521PubMed
33.
go back to reference Matsumata T, Ikeda Y, Hayashi H, et al. The association between transfusion and cancer free survival after curative resection for hepatocellular carcinoma. Cancer 1993;72:1866–1871PubMed Matsumata T, Ikeda Y, Hayashi H, et al. The association between transfusion and cancer free survival after curative resection for hepatocellular carcinoma. Cancer 1993;72:1866–1871PubMed
34.
go back to reference Yamamoto J, Kosuge T, Takayama T, et al. Perioperative blood transfusion promotes recurrence of hepatocellular carcinoma after hepatectomy. Surgery 1994;115:303–309PubMed Yamamoto J, Kosuge T, Takayama T, et al. Perioperative blood transfusion promotes recurrence of hepatocellular carcinoma after hepatectomy. Surgery 1994;115:303–309PubMed
Metadata
Title
Factors Associated with Disease Survival after Surgical Resection in Chinese Patients with Hepatocellular Carcinoma
Authors
Li Qiang
Li Huikai
Kelly Butt
P. Peter Wang
Xishan Hao
Publication date
01-03-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 3/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0608-6

Other articles of this Issue 3/2006

World Journal of Surgery 3/2006 Go to the issue