Clinicopathological features and surgical treatment of primary liver cancer

Objective: Clinicopathological features were considered in the surgical management of patients with primary liver cancer (PLC) with the evaluation of the outcome of liver resection. Methods: T wo hundred and twenty-three patients with PLC underwent hepatic resection as primary management for PLC from 1988to1996were retrospectively studied. 163cases of them were positive of HBsAg,189cases suffered from liver cirrhosis. TNM staging in stage Ⅰ/Ⅱ/Ⅲ/Ⅳ_A/Ⅳ_B were 6/52/125/27/13 cases,respectively. Histopathologic types are 207cases of hepatocellular carcinoma,12cases of cholangio-carcinoma,4cases of mixed liver carcinoma. Results: Overall operative mortality is 1. 8% (4/223),and total survival rate in 5years is 43. 3%,it is 54. 3% in group ≤ 5cm in diameter. And it is 61. 7%,22. 0% and 0% in pathologically curative resection,clinically curative resection and non-curative resection groups,respectively. Recurrence and metastasis rates in 1,3 and 5 years were 19. 8%, 48. 2% and 74. 6% in both curative resection groups. 50cases of PLC after 1~5 times TACE were sequentially resected,of which 5-year survival rate was 40. 5%. Conclusions: The resection rate of PLC is improved by early detection of small PLC and secondary resection of large PLC,and the outcome of hepatic resection are generally satisfactory;however,the recurrence and metastasis rate is still high.