Predictive factors for long-term survival after hepatic resection for hepatocellular carcinoma: a single-center experience

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Abstract

Aim
To evaluate our center’s experience of liver resection for hepatocellular carcinoma (HCC) to determine the predictive factors affecting tumor recurrence and long-term survival.
Patients and methods
We reviewed the data of all consecutive patients who underwent liver resection for pathologically confirmed HCC during the period between January 2010 and June 2018.
Results
A total of 230 consecutive patients were included in the study. Hepatitis C virus was the main underlying cause among our patients (214 patients − 93.04%). The median operation time was 180 min (70–420 min), and the median blood loss was 700 ml (100–6000 ml). Postoperative morbidities occurred in 138 (60%) patients. Internal hemorrhage occurred in six (2.6%) patients. A total of 12 (5.2%) patients experienced biliary complications. Liver dysfunction occurred in 126 (54.7%) cases, and most of them were only grade A liver dysfunction (70 patients − 55.5%). The median follow-up duration was 22 months (4–110 months). Recurrence occurred in 132 (62.5%) patients. The 1-, 3-, and 5-year disease-free survival rates were 69.2, 35.4, and 17.6%, respectively. Late mortality occurred in 61 (26.5%) patients. The 1-, 3-, and 5-year overall survival rates were 78.2, 59.1, and 50%, respectively. Predictive factors for recurrence included alpha-fetoprotein, tumor number, macrovascular invasion, tumor size, and microvascular invasion. Predictive factors for long-term survival included macrovascular invasion, vascular complications, tumor size, and microvascular invasion.
Conclusion
Liver resection is one of the curative treatment strategies for HCC; however, the long-term prognosis is disappointing owing to the high incidence of tumor recurrence.

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