Abstract
The mortality of the patients who undergo hepatectomies for malignant tumors is quite high. To clarify the reasons of the high mortality of resected hepatocellular carcinomas, the patients who underwent hepatic resections for hepatocellular carcinomas were analyzed. One hundred and ninety three hepatectomies were performed for hepatocellular carcinomas in the Department of Surgery, University of Tokyo, between January, 1963 and June, 1990. One hundred and thirty five were minor hepatectomies and 58 were major ones. The operative blood loss is little in the patients of hepatocellular carcinomas who underwent hepatectomies after January, 1981, in comparison with those who were done hepatectomies before May, 1981. The difference was statistically significant (p<0.05). The 5 year survival rates of hepatocellular carcinomas resected before May, 1981 and after June, 1981 were 19.4% and 37.9%, respectively. The difference was statistically significant (p<0.05). This improvement of prognosis is mainly due to developments of operative procedures, medical equipments such as ultrasonography and computed tomography, and intense studies on liver failure. The main cause of death of resected hepatocellular carcinoma is the recurrence of tumor. Many attempts of therapies have been applied to prevent from and treat for recurrences. It must be emphasized that the re-resection is one of the best therapies for recurrent hepatocellular carcinomas.
