BACKGROUND: The present study aimed to clarify the clinicopathologic features of long-term disease-fee survival after resection of hepatocellular carcinoma (HCC). METHODS: This retrospective study identified 940 patients who underwent curative resection of HCC between 1991 and 2000 at five university hospitals. Seventy-four patients with 10 years of recurrence-free survival were identified and followed up. They were divided into two groups, 60 recurrence-free and 14 with recurrence after a 10-year recurrence-free period. RESULTS: Overall survival rates of recurrence and non-recurrence groups were 68 and 91 % at 16 years, and 34 and 91 % at 20 years (p = 0.02), respectively. There were five (36 %), and two deaths (3 %), respectively, after 10 recurrence-free years. A second resection for recurrence was performed in four patients (29 %), and mean survival was 15.3 years after the first hepatectomy. Although three patients in the non-recurrence group (5 %) developed esophageal and/or gastric varices, seven patients in the recurrence group (50 %) developed varices during 10 years (p < 0.0001). In multivariate analysis, preoperative and 10-year platelet count was identified as a favorable independent factor for maintained recurrence-free survival after a 10-year recurrence-free period following curative hepatic resection of HCC. CONCLUSIONS: Recurrence of HCC may occur even after a 10-year recurrence-free period. Long-term follow-up after resection of HCC is important, and should be life-long. Patients with higher preoperative and 10-year platelet counts are more likely to have long-term survival after resection. A low platelet count, related to the degree of liver fibrosis, is a risk factor for recurrence and survival of HCC after curative resection.
BACKGROUND: The present study aimed to clarify the clinicopathologic features of long-term disease-fee survival after resection of hepatocellular carcinoma (HCC). METHODS: This retrospective study identified 940 patients who underwent curative resection of HCC between 1991 and 2000 at five university hospitals. Seventy-four patients with 10 years of recurrence-free survival were identified and followed up. They were divided into two groups, 60 recurrence-free and 14 with recurrence after a 10-year recurrence-free period. RESULTS: Overall survival rates of recurrence and non-recurrence groups were 68 and 91 % at 16 years, and 34 and 91 % at 20 years (p = 0.02), respectively. There were five (36 %), and two deaths (3 %), respectively, after 10 recurrence-free years. A second resection for recurrence was performed in four patients (29 %), and mean survival was 15.3 years after the first hepatectomy. Although three patients in the non-recurrence group (5 %) developed esophageal and/or gastric varices, seven patients in the recurrence group (50 %) developed varices during 10 years (p < 0.0001). In multivariate analysis, preoperative and 10-year platelet count was identified as a favorable independent factor for maintained recurrence-free survival after a 10-year recurrence-free period following curative hepatic resection of HCC. CONCLUSIONS: Recurrence of HCC may occur even after a 10-year recurrence-free period. Long-term follow-up after resection of HCC is important, and should be life-long. Patients with higher preoperative and 10-year platelet counts are more likely to have long-term survival after resection. A low platelet count, related to the degree of liver fibrosis, is a risk factor for recurrence and survival of HCC after curative resection.
Authors: T Kawasaki; A Takeshita; K Souda; Y Kobayashi; M Kikuyama; F Suzuki; F Kageyama; Y Sasada; E Shimizu; G Murohisa; S Koide; T Yoshimi; H Nakamura; R Ohno Journal: Am J Gastroenterol Date: 1999-07 Impact factor: 10.864
Authors: T Seki; M Wakabayashi; T Nakagawa; T Itho; T Shiro; K Kunieda; M Sato; S Uchiyama; K Inoue Journal: Cancer Date: 1994-08-01 Impact factor: 6.860
Authors: K Shirabe; M Shimada; K Kajiyama; T Gion; Y Ikeda; H Hasegawa; K Taguchi; K Takenaka; K Sugimachi Journal: Cancer Date: 1998-12-01 Impact factor: 6.860
Authors: Y Imai; S Kawata; S Tamura; I Yabuuchi; S Noda; M Inada; Y Maeda; Y Shirai; T Fukuzaki; I Kaji; H Ishikawa; Y Matsuda; M Nishikawa; K Seki; Y Matsuzawa Journal: Ann Intern Med Date: 1998-07-15 Impact factor: 25.391