Conditions favoring long-term survival after hepatectomy for hepatocellular carcinomas.

The present study was aimed at answering the question of what patients with hepatocellular carcinomas could obtain long-term benefits from resectional therapy. The 239 patients hepatectomized from 1973 through 1986, with 33 tumor-free, 3-year survivors, were the subjects of the study. The following criteria for long-term survival were determined. (a) It is essential that there are no macroscopic tumor thrombi in any of the vessels. (b) It is desirable that there is no daughter lesion and a tumor size of less than 5 cm. (c) When there are daughter lesions, they should be confined to the region adjacent to the main tumor and only few in number. (d) Resection should be performed on a large scale within the limit of safety, especially for the tumors with daughter lesions. (e) The surgical margin should be free of tumor though the exposure of the tumor capsule is not always incompatible with long survival.