World Journal of Surgery

, Volume 26, Issue 6, pp 742–747 | Cite as

Surgical results in patients with hepatitis virus-related hepatocellular carcinoma in Taiwan

Surgical Globetrotting

Abstract

To investigate the surgical results of hepatectomy for hepatocellular carcinoma in relation to hepatitis virus status in Taiwan, 252 patients (196 men and 56 women; March 1992 to August 1998) were reviewed. The patients were divided into four groups: 30 patients (11.9%) seronegative for both hepatitis B surface antigen (HBsAg) and antihepatitis C antibody (HCVAb) (N-HCC group); 133 patients (52.8%) seropositive for HBsAg and seronegative for HCVAb (B-HCC group); 66 patients (26.2%) seronegative for HBsAg and seropositive for HCVAb (C-HCC group); and 23 patients (9.1%) seropositive for both HBsAg and HCVAb (BC-HCC group). Patients in group C-HCC were older (p=0.001) and had a higher incidence of diabetes mellitus (p=0.004). Also, they had a higher indocyanine green retention rate at 15 minutes (p=0.021), longer international normalization ratio for the prothrombin time (p=0.049), and smaller tumor (p=0.006). Postoperative complications and hospital mortality were significantly higher in patients in the C-HCC and BC-HCC groups (p=0.046, 0.021). All patients were followed 12 to 76 months after hepatectomy (mean 23.5±16.3 months). The 1-, 3-, and 5-year overall cumulative survival rates of the 252 patients in this series were 80%, 54.3%, and 34.2%, respectively. The cumulative intrahepatic recurrence rates were 46.5%, 64.9%, and 72.9% at 1, 3, and 5 years, respectively. The mean disease-free survival time was longest in group C-HCC and shortest in group BC-HCC (p=0.020). The overall survival time and cumulative survival rates in the four groups were not significantly different (p=0.146).

Keywords

Hepatic Resection Cumulative Survival Rate Hepatitis Viral Status Mayor Edad Dual Hepatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Afin d’analyser les résultats de l’hépatectomie pour carcinome hépatocellulaire en rapport avec le virus de l’hépatite à Taiwan, on a revu les dossiers de 252 patients (196 hommes et 56 femmes), observés entre mars 1992 et août 1998. Les patients ont été divisés en 4 groupes, 30 patients (11.9%) séronégatifs pour l’antigène de surface de l’hépatite B (HBsAg) et l’anticorps antihépatite C (HCV4b) (groupe N-HCC), 133 patients (52.8%) séropositifs pour HBsAg et séronégatifs pour HCVAb (groupe B-HCC), 66 patients (26.2%) séronégatifs pour HBsAg et séropositifs pour HCVAb (groupe C-HCC) et 23 patients (9.1%) séropositifs pour HBsAg et HCVAb (groupe BC-HCC). Par rapport aux autres groupes, les patients dans le groupe C-HCC étaient plus âgés (p=0.001), avaient une incidence plus élevée de diabète (p=0.004), une rétention à 15 minutes de vert d’indocyanine plus élevée (p=0.021), un temps nécessaire à la normalisation du temps de prothrombine international, plus allongé (p=0.049) et une taille tumorale plus petite (p=0.006). Les complications postopératoires et la mortalité hospitalière étaient significativement plus élevées chez les patients C-HCC et BC-HCC (p=0.046 et 0.021, respectivement). Après leur hépatectomie, tous les patients ont été suivis pour une moyenne de 23.5±16.3 mois (12 à 76 mois). Les taux cumulatifs de survie globale à 1, 3, et 5 ans chez les 252 patients dans cette série ont été, respectivement, de 80%, de 54.3% et de 34.2%. Les taux cumulatifs de récidive intrahépatique ont été de 46.5%, de 64.9% et de 72.9% à 1-, 3-, et 5 ans, respectivement. Le temps moyen de survie sans maladie était le plus long dans le groupe C-HCC et le plus court dans le groupe BC-HCC (p=0.020). Cependant, la survie globale et le taux cumulatif de survie dans les quatre groupes ne différaient pas de façon significative (p=0.146).

Resumen

Con el fin de investigar los resultados de la hepatectomía por carcinoma hepatocelular en relación con el estado del virus de la hepatitis en Taiwan, se revisaron 252 pacientes (196 hombres y 56 mujeres vistos entre marzo de 1992 y agosto de 1998), los cuales fueron divididos en 4 grupos: 30 (11.9%) seronegatives para antígeno de superficie de hepatitis B (HBsAg) y para anticuerpos antihepatitis C (HCVAb), Grupo N-HCC; 133 (52.8%) seropositives para HBsAg y seronegatives para HCVAb, Grupo B-HCC; 66 (26.2%) seronegatives para HBsAg y seropositives paa HCVAb, Grupo C-HCC; y 23 (9.1%) seropositives para HBsAg como para HCVAb, Grupo BC-HCC. Los pacientes del grupo C-HCC fueron de mayor edad (p=0.001) y con una mayor incidencia de diabetes mellitus (p=0.004), y también con tasas de retención a 15 minutes de verde indocianina más elevadas (p=0.021), mas prolongada normalización internacional de la razón del tiempo de protrombina (p=0.049) y menor tamaño del tumor (p=0.006). Las tasas de complicaciones postoperatorias y de mortalidad hospitalaria fueron significativamente más elevadas en los pacientes en los grupos C-HCC y BC-HCC (p=0.046, 0.021). Todos los pacientes fueron seguidos entre 12 y 76 meses luego de la hepatectomía, con un seguimiento promedio de 23.5±16.3 meses. Las tasas globales acumulativas de supervivencia a 1, 3 y 5 años fueron 80%, 54.3% y 34.2%, respectivamente. Las tasas acumulativas de recurrencia fueron 46.5%, 64.9% y 72.9% a 1, 3 y 5 años respectivamente. El tiempo promedio de supervivencia libre de enfermedad fue más prolongado en el grupo C-HCC y más corto en el grupo BC-HCC (p=0.020). Sin embargo, ni la tasa global de supervivencia ni la tasa acumulativa de supervivencia exhibieron diferencias significativas entre los cuatro grupos (p=0.146).

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Copyright information

© Société Internationale de Chirurgie 2002

Authors and Affiliations

  1. 1.Department of General SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
  2. 2.Department of General SurgeryChang Gung UniversityTaipeiTaiwan

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