The Clinical Research Of 120 Cases Of Small Hepatocellular Carcinoma After Curative Resection

ObjectiveTo study the prognostic factors and relevant countermeasures of small hepatocellular carcinoma (SHCC) after curative resection.MethodIt was retrospectively analyzed that the clinical and pathologic date of 120 patients who underwent curative resection for SHCC in the affiliated tumor hospital of Guangxi Medical University from January 2002 to December 2006,among that 53 patients was found in the high incidence area of hepatocellular carcinoma (HCC) in Guangxi Guangxi zhuang autonomous region when for the census work of hepatocellular carcinoma. According the clinical factors included age, sex, preoperative serum alpha fetoprotein (AFP) level, liver function Child-Pugh grades, tumor maximum diameter, liver cirrhosis degree, the tumor peplos status and the modus operandi that was simple tumor excision or excision which including lobes and segments of liver to divided the all 120 patients into different groups.The univariate analysis and multivariate analysis were deployed to compare the survival rate and recurrence rate between groups, to investigate the prognostic factors and relevant countermeasures of SHCC that after curative resection.ResultsThe 1-,3-,5-years accumulative survival rate of the all 120 patients was 90.8%,73.1%,61.0%. The 1-,3-,5-years accumulative survival rate of the group tumor diameter which was smaller than or equal to 3 cm was 98.0%,86.5%,64.0%, and the 1-,3-,5-years accumulative survival rate of the group tumor diameter which was larger than 3 cm but smaller than 5 cm was 81.0%,66.0%,56.3%.The 2-,5-accumulative recurrence rate of the group tumor diameter which was smaller than or equal to 3 cm was 11.3%,26.4%, and the 2-,5-accumulative recurrence rate of the group tumor diameter which was larger than 3 cm but smaller than 5cm was 28.4%,52.2%, there were significant differences between two groups(p<0.05). The 1-,3-,5-years accumulative survival rate of the group normal liver function was 93.1%,84.9%,66.9%, and there was83.9%,60.6%,51.1%in the group abnor-liver function. The 1-,3-,5-years accumulative survival rate of the group which had complete tumor peplos was 94.9%,80.3%,65.0%,and the group no-peplos was 76.2%,60.5%,52.3%. The 1-,3-,5-years accumulative survival rate of the group liver cirrhosis was 84.1%,63.4%,46.5%,and there was 93.0%,80.8%,66.9% in the group no-liver cirrhosis. The 1-,3-,5-years accumulative survival rate of the group excision. including lobes and segments of liver was 91.7%,72.5%,66.5%,and the group simple tumor excision was 87.5%,77.1%,52.5%. According to the result of univariate analysis, the liver function Child-Pugh grades, tumor maximum diameter, liver cirrhosis status, the tumor peplos status were the prognostic factors of small HCC that after curative resection. And the liver cirrhosis degree was found to be one of the independent prognostic factors of small HCC by the multivariate analysis.Conclusions(1) The liver function Child-Pugh grades, tumor maximum diameter, liver cirrhosis status, the tumor peplos status were the prognostic factors of small HCC that after curative resection.And the liver cirrhosis degree was found to be one of the independent prognostic factors of small HCC.(2) For the definition of small HCC, and can be considered as a tumor maximum diameter smaller than 5cm in diagnostic criteria is accurate, and could be convenient for clinical application(3) Limited hepatectomy with a margin no less than 1.5 cm is an appropriate and reliable surgical approach for small HCC.(4) For the people with liver disease background, including the middle-aged male patient with HBV infection, especially who with cirrhosis and family medical history has did serum AFP and B-sonography check regularly is necessary to earlier finding early hepatocellular carcinoma, and to get early diagnosis and treatment.