SURGICAL TREATMENT FOR HEPATOCELLULAR CARCINOMA (HCC) LESS THAN 5 CM IN DIAMETER

Abstract

The therapeutic outcome after hepatic resection for hepatocellular carcinomas (HCC) smaller than 5cm in diameter was examined in 65 patients followed up for more than 6 months postoperatively. Patients were divided into two groups: patients with solitary tumors (ST, n=46) and those with two or more tumors (n=19). The latter group was subdivided into an intrahepatic metastasis (IM) group (n=10), and multicentric occurrence (MT) group (n=9). There was one perioperative death (1.5%), and 21 patients suffered from postoperative complications (32.3%). The overall 1-year, 3-year, and 5-year survival rates were 86.1%, 72.3%, and 44/7%, respectively. The 3-year survival rate was significantly higher in the MT than IM group (86% versus 42%, p<0.05). Survival rates in the ST group were 89%, 78%, and 52% at 1, 3 and 5 years respectively. When the survival rates of the ST group were reexamined by tumor diameters, the 1-, 3-, and 5-year survival rates of patients with a tumor smaller than 3cm in diameter were 87%, 69%, and 40%, respectively, which were unexpectedly poor. The overall recurrence rate was 43.1% (28 cases). There was no significant difference in recurrence rate among groups. It is concluded that surgical treatment is indicated for multicentric HCC, and surgery in the patients with small HCC (_??_3cm) should be limited to those with good hepatic function (TR_??_2.4).