Abstract
Partial resection and systematic resection for hepatocellular carcinoma combined with liver cirrhosis were evaluated according to postoperative metachronous multicentric carcinogenesis and postoperative quality of life (QOL). The 5-year survival rate was 45.0% after partial resection and 42.9% aftersystematic resection; there was no significant difference between the rates. According to the comparison of histologic grade of the resected tumor and recurrence of the tumor in 24 patients, in 14 patients (58.3%) recurrence was due to postoperative metachronous multicentric carcinogenesis and in 9 patients (37.5%) it was due to metastasis. In7 of these 9 patients, the site of the recurrent tumor was a different segment from that of the resected tumor, even though the recurrence was due to metastasis. The length of hospitalization for resection and the total postoperative hospitalization was investigated and the hospitalization tended to be longer in patients who received systematic resection or who also had severe liver cirrhosis. These results indicate that systematic resection, such as subsegmentectomy or segmentectomy, should not be performed only to prolong life but also to improve the QOL. However, there was no correlation of QOL scores from our assessment with the resection method nor the degree of liver cirrhosis. The difficulty of an objective evaluation of QOL in patients with hepatocallualr carcinoma combined with liver cirrhosis is empahasized.
