RESULTS OF HEPATECTOMY FOR 600 CASES WITH PRIMARYLIVER CANCER

Hepatic resection had been performed in 600 cases with primary liver cancer (PLC) in our hospital from 1964 to 1993. Among them, 24 cases underwent second hepatic resection because of tumor recurrence. The ratio of male to female was 8.0:1. Most of the patients were 40 to 59 years old and the age ranged from 8 to 78 years old. The positive rate of AFP was 57.4% (>400 gg/L). Of them, 84.4% were associated with hepatic cirrhosis. Hepatocellular carcinoma was verified in 91.6% of these cases. Small tumor (<5 cm in diameter) was found in 130 cases (21,7%). In this series, 10 cases underwent semi-hepatectomy and 590 cases underwent irregular hepatectomy. Spontaneous tumor rupture was found in 29 cases. In 13 of 600 cases, hepatectomy was done after TAE (transcatheter hepatic arterial chemoembolization). Six of 600 cases underwent second stage hepatectomy since the tumors could not be resected during laparotomy. After multimodality therapy, including tumor ethanol injection, microwave tumor coagulation and hepatic artery chemoembolization, these tumors became small and subsequently resected. In these 600 cases, 24 cases died within one month after hepatectomy with a mortality of 4.0%. The most common cause of death was hepatic failure. The 1-, 3-, 5- and 10- year survival rates were 61.9%, 40.2%, 33.0% and 29.2%, respectively in the whole series and 87.8%, 69.4%, 54.0% and 43.0%, respectively in the patientswith small tumor.