Clinical examination of hepatocellular carcinoma treated at the department of surgery, public fujioka general hospital.

Abstract

We clinically examined 137 patients with hepatocellular carcinoma (99 males, 38 females, mean age : 65.7 years) who were treated at the Department of Surgery, Public Fujioka General Hospital between June 1989 and December 1997. The proportion of HBsAg-positive patients was 5.1%. The proportion of HCV-positive patients was 83.2%. The incidence of liver cirrhosis was 90%.The clinical stage was evaluated as I in 24.8% of the patients, II in 54.0% of the patients and III in 21.2% of the patients. In most patients, hepatic functional reserve was reduced. Concerning the number of tumors, 46% of the patients had solitary tumor, while 25.5% of the patients had 5 or more tumors. More than half the patients had multiple tumors. The maximal mean tumor diameter was 5.6 cm. According to staging, 5.8%, 29.9%, 10.2%, 46.0% and 8.0% of the patients had stage-I, -II, -III, -IV A and-IV B lesions, respectively.Surgery was performed in 22.6% of the patients. There were no surgical deaths. In the hepatectomy group, 1-year, 3-year and 5-year cumulative survival rates were 84.6%, 63.8% and 54.9%, respectively. In the TAE group, 1-year and 3-year cumulative survival rates were 54.9% and 24.9%, respectively. In the LPD group, 1-year, 3-year and 5-year cumulative survival rates were 68.4%, 13.0% and 13.0%, respectively. In the arterial infusion group with a reservoir, the 1-year cumulative survival rate was 31.5%.Therefore, hepatectomy may be effective for patients in whom surgery is possible. In patients in whom surgery is impossible, TAE, LPD and arterial infusion with a reservoir may prolong survival.