TREATMENT OF HEPATOCELLULAR CARCINOMA IN VIEW OF THE PROGNOSTIC FACTORS

Abstract

Seventy-eight resected cases of hepatocellular carcinoma were subjected to a study of the correlation between prognosis and prognostic factors which are prescribed in the General Rules for the Hepatic Cancer Study, and in this paper, the strategy of treatment for hepatocellular carcinoma in our institution is also described. In an analysis of the cumulative survival rates, the prognosis was correlated with 8 tumor factors including preoperative AFP value, maximum tumor diameter, number, histologic differentiation grade of the tumor, fc-inf, vp, vv, and im. Besides these 8 factors, it correlated with two background factors including the presence of liver cirrhosis and necrosis rate in tumors by TACE. Moreover, in the disease free survival rate, prognosis was correlated with 7 factors including preoperative AFP value, maximum tumor diameter, number, vp, im, the presence of liver cirrhosis and necrosis rate of the tumor. Adjuvant treatments such as arterial injection chemotherapy might be necessary when the poor prognostic factors (more than 5cm in maximum tumor diameter, vp and im) existed at the initial operation. As for the treatment of recurrent cases, an improvement of the prognosis was obtained only by reoperation when the recurrence had occurred more than 2 years after the initial operation and when the tumors had been restricted in the functionally resectable segment(s). Multimodal treatments including TACE, PEIT and arterial infusion chemotherapy may be needed when the recurrence occurs within two years after surgery.