Analysis of Outcome and Prognostic Factors in Liver Resection for HCC

Introduction: The aim of this study is to examine the factors associated with improved prognosis in HCC after liver resection. Methods: From September 1989 to March 2005, 134 consecu- tive patients had liver resection for HCC on cirrhosis at our department. We performed 54 major liver resections and 80 limited resections. Allpatients enrolled in the study were followed-up three times during the first year after resection and twice the next years. Results: In-hospital mortality rate was 7.4%, about 50% of these cases were Child-Pugh B patients. Morbidity rate was 47.7%, caused by the rising of ascites, hepatic insufficiency, biliary fistula, hepatic abscess, hemoperitoneum and pleural effusion. Overall sur- vival resulted to be influenced by etiology (p 0.03), underlying liver disease, in particular Child A vs. BC (p 0.04), Endmondson- Steiner grading (p0.01), and the associated variables Grading 1–2 Child A vs. Grading 3–4 Child BC (p 0.03), the absence of a capsule (p 0.004), the presence of more than one lesion (p 0.02), the measure of lesion more than 5 cm (p 0.04), Pringle maneuver length more than 20 min (p 0.03), the amount of resected liver volume more than 50% of total liver volume (p 0.03), and the relapse of HCC (p 0.01). Conclusion: A better preoperative selection of patients, based on a defined panel of criteria could improve survival, reduce postop- erative complications and recurrence’s rate after liver resection.