During Jan. 1960 ― Dec. 1998. 5524 patients with pathologically proven primary liver cancer(PLC) underwent hepatectomy in our hospital. The overall surgical outcome was improved gradually as the postoperative five-year survival rate was 16.0 % between 1960 - 1977(n = 181), 30.6 %between 1978 - 1989 (n = 921) and 48.6 % between 1990 - 1998 (n = 4422). The operation mortality decreased from 8.48 %. 0.43 % to 0.31 % during the various periods. These data indicated the progress in clinical research of PLC, as well as the importance of surgery. For surgical technical aspects, normothermic intermittent interruption of portal hepatis,transection with finger-fracture and forceps, radical local resection and management of huge tumor involving portal hepatis and IVC were the main approach in our series. The postoperative recurrence remains to be a target for further improving surgical results. However, tumor-free survival could be increased by the way of early detection and resection, preoperative TACE, avoidence of squeezing the tumor to prevent iatrogenic dissemination, postoperative comprehensive treatment and reoperation. The two-stage operation was only indicated for a part of the unresectable PLC but not suitable for all large tumor involved portal hepatis or IVC. The resectability should be judged finely and carefully.
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