Hepatic resection provided long-term survival for patients with intermediate and advanced-stage resectable hepatocellular carcinoma

摘要

Background Hepatic resection has the highest local controllability that results in long-term survival for hepatocellular carcinoma (HCC). This study aimed to investigate the role of hepatic resection in selected patients of intermediate and advanced stage. Methods Clinical, pathological, and outcome data of 542 consecutive patients were retrospectively analyzed from a single center. The Kaplan-Meier method was used to estimate survival. Postoperative prognostic factors were evaluated using univariate and multivariate analyses. Results The 1-, 3-, and 5-year overall survival rates were 89.0, 64.3, and 53.0?%, respectively. The 1-, 3-, and 5-year disease-free survival rates were 72.2, 44.5, and 34.2?%, respectively. Preoperative α-fetoprotein level >400?ng/mL, macroscopic vascular invasion, microscopic portal vein thrombosis, multiple tumor nodules, and the largest tumor size >5?cm were significantly correlated with overall survival. When these clinical risk factors were used in a postoperative staging system, assigning one point for each factor, the total score was precisely predictive of long-term survival. For patients with surgery plus adjuvant TACE (transarterial chemoembolization), the median overall survival was 56?months (range 1–110?months) and the 5-year OS rate was 48.5?%. Conclusions Hepatic resection is efficient and safe for HCC patients of intermediate and advanced stage. The adjuvant TACE should be recommended for HCC patients with poor risk factors.