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Treatment results and prognostic factors in resectable hepatocellular carcinoma—Results from a local general hospital

Chang-Kuo Weia, †, Shiang-Jiun Tsaib, †, Wen-Yao Yina, c, Chun-Ming Changa, Wen-Yen Chioub, Moon-Sing Leeb, c, Yu-Chieh Suc, d, Hon-Yi Linb, c, Shih-Kai Hungb, c

a Department of General Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
b Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
c School of Medicine, Tzu Chi University, Hualien, Taiwan
d Department of Hematological Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

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Abstract
Objective

Hepatocellular carcinoma (HCC) is a common cause of cancer mortality. Resection is the best choice for HCC. Our objective was to evaluate the impact of various factors that affected survival in patients with resectable HCC.

Materials and methods

Between January 1, 2007 and December 31, 2013, 107 patients with a diagnosis of HCC who underwent surgery were enrolled retrospectively. The analysis was carried using t tests, the Kaplan–Meier method, and Cox proportional hazard regression model to identify potential confounding and predicting variables.

Results

The 3-year overall survival rates in patients with surgical margins >1 mm and ≤1 mm were 79% and 59% (p = 0.02), respectively, and those in patients with and without vascular invasion were 57% and 93% (p < 0.001), respectively. Based on multivariate analysis, postoperative pathological vascular invasion (hazard ratio, 6.25; 95% confidence interval, 2.01–19.37) and surgical margin (hazard ratio, 0.37; 95% confidence interval, 0.14–0.96) remained independent predictors of an adverse long-term outcome.

Conclusion

Patients with vascular invasion combined with surgical margins ≤1 mm are at risk of poor survival and have a worse locoregional control rate. Further studies are warranted to identify the optimal strategy for the prevention and management of intrahepatic recurrence in order to further improve the prognosis of HCC after resection.

Keywords
Adjuvant therapy; Hepatocellular carcinoma; Surgical margin; Vascular invasion


 

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