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Improved Long-term Survival after Liver Resection for Hepatocellular Carcinoma in the Modern Era: Retrospective Study from HCV-endemic Areas

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Abstract

Introduction

It remains unclear whether recent progress in perioperative management and treatment for recurrent hepatocellular carcinoma (HCC) has improved patient outcomes in hepatitis C virus-endemic areas.

Methods

The clinicopathologic and follow-up data of 218 consecutive HCC patients who underwent curative resection between 1982 and 2003 were analyzed. Patients were assigned to one of two groups: before 1992 (early group; n = 82) and 1992 and later (late group; n = 136). Factors influencing survival rates were investigated by multivariate analysis. The effects of the period during which the hepatic resection was done on the patients’ outcome were examined with respect to tumor size.

Results

The 5-year cancer-related and disease-free survival rates were 51.4% and 20.4%, respectively. The late group showed better 5-year cancer-related survival than the early group (64.1% vs. 33.8%), but disease-free survival did not differ significantly between the groups. On multivariate analysis, the period of the hepatic resection was identified as an independent prognostic factor for cancer-related survival (relative risk 0.70, P < 0.01) but not disease-free survival. There were no differences in the cancer-related and disease-free survival rates between the two groups for patients with tumors ≤ 25 mm. In patients with HCCs > 50 mm, both cancer-related and disease-free survival rates were better in patients in the late group.

Conclusions

During the past two decades, improvements in the treatment of recurrent HCC tumors have contributed to controlling large HCCs but not to controlling the multicentric development of HCCs. It may be important to control multicentric recurrence of HCC to improve patient survival in areas where the hepatitis C virus is endemic.

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Acknowledgment

This work was supported in part by a grant-in-aid from the JSPS Fujita Memorial Fund for Medical Research.

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Authors and Affiliations

  1. Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan

    Atsushi Sasaki MD, PhD, Yukio Iwashita MD, PhD, Kohei Shibata MD, PhD, Toshifumi Matsumoto MD, PhD, Masayuki Ohta MD, PhD & Seigo Kitano MD, PhD

  2. Department of Surgical Oncology, Medical Institute of Bioregulation, Kyushu University, Beppu, 874-0838, Japan

    Atsushi Sasaki MD, PhD

Authors
  1. Atsushi Sasaki MD, PhD
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  2. Yukio Iwashita MD, PhD
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  3. Kohei Shibata MD, PhD
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  4. Toshifumi Matsumoto MD, PhD
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  5. Masayuki Ohta MD, PhD
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  6. Seigo Kitano MD, PhD
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Correspondence to Atsushi Sasaki MD, PhD.

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Sasaki, A., Iwashita, Y., Shibata, K. et al. Improved Long-term Survival after Liver Resection for Hepatocellular Carcinoma in the Modern Era: Retrospective Study from HCV-endemic Areas. World J. Surg. 30, 1567–1578 (2006). https://doi.org/10.1007/s00268-005-0249-9

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  • DOI: https://doi.org/10.1007/s00268-005-0249-9

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