Abstract

Background/Aim
s: This study was conducted to develop an optimal strategy to achieve a long-term survival after liver resection for hepatocellular carcinoma. Methods: Between July 1975 and March 1995, 109 patients who underwent liver resection for hepatocellular carcinoma at Inje University Seoul Paik Hospital were analyzed retrospectively. Results: Thirty-eight patients (34.9%) survived longer than 5 years after operation. Prognostic factors of statistical significance were the diagnostic clue, ICG R15, TNM stage, extent of tumor, intrahepatic metastasis, portal vein thrombosis, serosal interval. For 63 cases with no intrahepatic metastasis, there was no survival difference between the lobectomy group and the segmentectomy/subsegmentectomy group (36.8% vs. 50.0%). In the subset of patients with satellite nodules confined to one single segment of the liver, 66.7% of the those who underwent lobectomy lived longer than 5 years while only 17.6% of the patients who had a lesser resection survived long-term(p=0.025). Conclusion: For the achievement of a long-term survival in patients with hepatocellular carcinoma, a systematic segmentectomy/subsegmentectomy is adequate for those with no intrahepatic metastasis, while the presence of satellite nodules in one segment calls for a standard hepatic lobectomy.

• Keywords: Hepatocellular carcinoma;Liver resection;Long-term survival