This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Estimation of prognosis after hepatectomy for hepatocellular carcinoma. BJS 2002; 89: 311-316.
Published: 5th November 2002
Authors: W.‐C. Lee, L.‐B. Jeng, M.‐F. Chen
Background
The preferred means of treatment for hepatocellular carcinoma is surgical resection. However, the tumour recurrence rate is high. Accurate estimation of the risk of tumour recurrence after hepatectomy may facilitate the administration of adjuvant therapy after hepatectomy to patients with a high likelihood of tumour recurrence.
Method
The clinical and pathological profiles of 176 patients undergoing hepatectomy for hepatocellular carcinoma from March 1992 to August 1998 were reviewed. The Kaplan–Meier method and log rank test were used to analyse univariate prognostic factors. The Cox proportional hazard model was used for multivariate analysis. Disease‐free and overall cumulative survival rates were estimated with respect to the number of prognostic factors.
Results
Independent factors associated with a lower disease‐free survival included the presence of venous infiltration, presence of daughter tumours, absence of tumour encapsulation and tumour size exceeding 5 cm. Factors decreasing the overall survival rate included the presence of venous infiltration, absence of tumour encapsulation and surgical resection margin less than 1 cm. The 1‐year disease‐free survival rate decreased from 77·5(s.e. 5·6) to 14·0(8·5) per cent when the number of risk factors present increased from zero to three. The 5‐year survival rate decreased from 60·2(11·7) per cent to zero when the number of risk factors increased from zero to three.
Conclusion
The deterioration of disease‐free or overall survival of patients with hepatocellular carcinoma after hepatectomy correlates with increasing number of risk factors. The number of risk factors can be employed to accurately estimate disease‐free and overall survival. © 2002 British Journal of Surgery Society Ltd
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