Clinicopathological Study of Hepatocellular Carcinoma in Relation to Tumor Size

ABSTRACT: In order to evaluate the factors affecting the patient's survival, 32 patients of hepatic resection in which the liver had a sollitary hepatocellular car-cinoma (HCC) smaller than 5 cm in size were studied. 1) Chronic liver diseases were associated in 96.9 % of patients. Minor resection was done in 30 patients, and right hepatectomy in two. 2) 87.5 % of all cases were diagnosed during periodic follow-up examination for the patients with chronic liver disease, mostly cirrhosis. For small HCC, ultrasonography (US) had the highest detection rate (90%) compared with CT (66.7%) and angiography (55.6%). Preoperative serum AFP values were abnormal in 73%. 3) Grossly, all tumors were nodular or expanding and none was diffuse. Encapsulation appeared to be complete as tumor grew. Portal vein tumor thrombus (12.5%) and/or satellite tumor (31.2%) were frequent in those with larger than 2 cm in diameter. 4) The mortality rate was 9.4 % and the hospital mortality rate was 6.3 %. The survival rate of the group with small HCC was far better than that of the groups with HCC larger than 2 cm in size (p<0.05). Above findings indicate that early detection of the tumor without portal vein thrombus and/or satellite tumor, and an adequate hepatic resection such as subsegmentectomy or segmentectomy are most improtant for the patient's survival