Abstract
BackgroundHepatic resection has the highest local controllability that results in long-term survival for hepatocellular carcinoma (HCC). This study aimed to investigate the role of hepatic resection in selected patients of intermediate and advanced stage.MethodsClinical, pathological, and outcome data of 542 consecutive patients were retrospectively analyzed from a single center. The Kaplan-Meier method was used to estimate survival. Postoperative prognostic factors were evaluated using univariate and multivariate analyses.ResultsThe 1-, 3-, and 5-year overall survival rates were 89.0, 64.3, and 53.0 %, respectively. The 1-, 3-, and 5-year disease-free survival rates were 72.2, 44.5, and 34.2 %, respectively. Preoperative α-fetoprotein level >400 ng/mL, macroscopic vascular invasion, microscopic portal vein thrombosis, multiple tumor nodules, and the largest tumor size >5 cm were significantly correlated with overall survival. When these clinical risk factors were used in a postoperative staging system, assigning one point for each factor, the total score was precisely predictive of long-term survival. For patients with surgery plus adjuvant TACE (transarterial chemoembolization), the median overall survival was 56 months (range 1–110 months) and the 5-year OS rate was 48.5 %.ConclusionsHepatic resection is efficient and safe for HCC patients of intermediate and advanced stage. The adjuvant TACE should be recommended for HCC patients with poor risk factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-016-0811-y) contains supplementary material, which is available to authorized users.
Highlights
Hepatic resection has the highest local controllability that results in long-term survival for hepatocellular carcinoma (HCC)
Hepatic resection is considered as the first-line therapeutic option for HCC among all treatments [4]
The present study containing 542 consecutive patients represents an institutional review of surgical resection as the initial primary therapy for HCC from tertiary referral hospital
Summary
Hepatic resection has the highest local controllability that results in long-term survival for hepatocellular carcinoma (HCC). Hepatocellular carcinoma, the most common primary cancer of the liver, ranks sixth among malignant tumors in incidence and is the third leading cause of cancer-related death [1]. In China, owing to the high prevalence of hepatitis B viral infection and associated liver cirrhosis, hepatocellular carcinoma (HCC) accounts for more than 54 % of the world annual incidence, with an estimated 372,079 mortalities [2, 3]. The prognosis for patients with HCC remains discouraging due to the recurrence of HCC which is the main problem postoperatively and the 5-year overall survival rate which is only 34 to 50 % [8]. The Barcelona Clinic Liver Cancer (BCLC) staging classification is widely adopted because it is the only staging system that links prognostic classification to treatment
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