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Clinicopathologic features of patients with hepatocellular carcinoma surviving >10 years after hepatic resection
Author(s) -
Shirabe Ken,
Shimada Mitsuo,
Kajiyama Kiyoshi,
Gion Tomonobu,
Ikeda Yasuharu,
Hasegawa Hirofumi,
Taguchi Kenichi,
Takenaka Kenji,
Sugimachi Keizo
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19981201)83:11<2312::aid-cncr10>3.0.co;2-6
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , liver function , hepatectomy , antibody , hepatitis c virus , indocyanine green , incidence (geometry) , hepatitis b virus , surgery , virus , resection , immunology , physics , optics
BACKGROUND This study was performed to clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients surviving >10 years after hepatic resection. METHODS Between January 1971 and April 1987, 142 patients underwent hepatic resection. Thirty‐nine patients who died of surgical morbidity (surgical mortality rate: 27.5%) were excluded from this study. Among the 103 patients who survived and were observed for >10 years after surgery, 12 patients (11.7%) survived >10 years after hepatectomy. The surviving patients were divided into 2 groups: 10‐year survivors (n = 12) and nonsurvivors (n = 91). A comparative study between the two groups was made. RESULTS Preoperative liver function tests such as the indocyanine green retention test at 15 minutes and albumin levels showed that 10‐year survivors had better liver function than nonsurvivors. With regard to virus markers, 5 of 12 patients (41.7%) were positive for hepatitis B surface antigen (HBs‐Ag) and the incidence of hepatitis B virus‐related HCC was significantly higher than in nonsurvivors ( P = 0.020). The results also showed that 4 of 12 long term survivors had hepatitis C virus (HCV) antibody and 1 patient did not have any HCV antibody or HBs‐Ag. In two other patients, the HCV antibody was not measured and HBs‐Ag was negative. Among four patients with the HCV antibody, the serum HCV RNA concentration, measured by branched DNA probe assay, was <0.5 in 3 patients and 1.72 in 1 patient. Therefore, the HCV RNA concentration tended to be lower in 10‐year survivors. Tumor recurrence occurred in 8 of the 10‐year survivors. Solitary recurrence was observed in five patients whereas multiple recurrence was observed in three patients. All five patients with solitary recurrence underwent a second resection. CONCLUSIONS Based on the results of the current study, good liver function, HBs‐Ag positivity, and a low concentration of serum HCV RNA in HCV‐related HCC should be considered potentially good predictors of a long term survival. Cancer 1998;83:2312‐2316. © 1998 American Cancer Society.