Poor Prognostic Factors Of Hepatectomy In Patients With Small Hepatocellular Carcinoma

Purpose: To investigate the prognostic factors that can influence the recurrence and postoperative survival in patients with small hepatocellular carcinoma.Methods:From September 2004 to September 2009,98 patients with small hepatocellular carcinoma who underwent hepatectomy by the Union Hospital affiliated to Fujian Medical University were reviewed. Survival rate was calculated by Kaplan-Meier estimation while survival curve was analysed by log-rank test. Prognostic factors were studied by multivariate analysis with COX proportional hazards survival model.Results:17 patients with small hepatocellular carcinoma who underwent hepatectomy died up to the time of following up. They all died of recurrence or metastasis of hepatocellular carcinoma. The survival time of all was 5 to 73 months and the median survival time was 31 months. The cumulative survival rates of 12,24 and 36-month were 99.0%,87.7% and 82.5% respectively. Multivariate COX regression indicated that heavy smoking, ascites, microscopic vessel tumor thrombi, multiple lesions, tumor size were the factors affecting postoperative survival. In the 98 patients with small hepatocellular carcinoma who underwent hepatectomy,52 patients had tumor recurrence or metastasis. The disease-free survival time of all was 1 to 73 months and the median disease-free survival time was 24 months. The cumulative survival rates of 12,24 and 36-month were 72.4%,57.8% and 45.5% respectively. Multivariate COX regression indicated that microscopic vessel tumor thrombi, multiple lesions and the intraoperative blood loss were the factors affecting disease-free survival.Conclusion:The survival of patients with small hepatocellular carcinoma who underwent hepatectomy was affected by a number of factors. Patients with multiple lesions, large tumor size, microscopic vessel tumor thrombi or ascites have a poor prognosis. The heavy smoker would have a shorter survival time than the other patients. Microscopic vessel tumor thrombi and multiple lesions are the poor prognostic factors of the disease-free survival. Reducing of the dose of intraoperative blood loss may decrease the recurrence.