Authors: XinDa Zhou ZhaoYou Tang ZengChen Ma Jia Fan ZhiQuan Wu LunXiu Qin Jian Zhou Yao Yu HuiChuan Sun ShuangJian Qiu
Publish Date: 2009/03/18
Volume: 135, Issue: 8, Pages: 1067-1072
Abstract
By March of 2007 676 36/53 patients are still alive disease free 57 3/53 patients died of tumor recurrence or metastasis 113 6/53 patients died of liver failure 57 5/53 patients were lost during followup The longest patient survived 43 years and 2 months Five young patients got married after resection and have had babies One patient with a tumor measuring 17 × 13 × 9 cm largest tumor in this series survived for 37 years after resection still alive free of disease Reresection for recurrence was done in nine patients mean survival being 26 years and 11 months Reresection for solitary pulmonary metastasis was carried out in three patients mean survival being 29 years and 2 months In comparison with patients surviving 20 years patients surviving ≥20 years were significantly younger P = 0031 had a higher incidence of asymptomatic tumors 566 vs 344 P = 0002 lower γglutamyl transpeptidase level ≤50 U/L 642 vs 259 P 0000 lower proportion of liver cirrhosis 660 vs 836 P = 0002 higher percentage of small tumors ≤5 cm 623 vs 299 P 0000 single nodule tumors 906 vs 629 P 0000 and wellencapsulated tumors 868 vs 436 P 0000 lower proportion of tumor emboli in the portal vein 38 vs 225 P = 0002 better differentiation of tumor cells Edmondson grade I 216 vs 91 P = 0036 and higher curative resection rate 100 vs 641 P 0000Early detection and curative resection are the principal factors improving longterm survival Longterm followup after resection of HCC is very important and should continue for the remainder of the patient’s life Reresection for recurrence and metastasis is important approach to improve prognosis
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