Hong Kong Med J 1999;5:353–9 | Number 4, December 1999
Hepatic resection for primary liver cancer at a private community hospital: retrospective study of 61 patients
MH Shiu, DLS Siu, WM Hui, HC Yu, KC Lam
The Hong Kong Sanatorium and Hospital, 2 Village Road, Happy Valley, Hong Kong
OBJECTIVE. To review the outcome after surgical resection for primary liver cancer.
DESIGN. Retrospective study.
SETTING. Private community hospital, Hong Kong.
PATIENTS. Sixty-one consecutive patients who underwent liver resection for primary cancer from 1992 through 1997.
MAIN OUTCOME MEASURES. Clinicopathological features, type of resection, duration of hospital stay, and actuarial overall and disease-free 5-year survival rates.
RESULTS. Cirrhosis was present in 46 (75%) of the patients, and 42 (69%) were positive for hepatitis B surface antigen. The median tumour diameter was 8 cm (range, 1-16 cm). Liver resections consisted of hemihepatectomy (n=37), trisegmentectomy (n=4), segmentectomy (n=11), and wedge resection (n=9). Postoperative death and major morbidity occurred in 0% and 36% of patients, respectively; ascites was the most common complication. The median hospital stay was 11 days. The actuarial overall and disease-free 5-year survival rates were 36.0% and 22.8%, respectively. These results are similar to or better than those recently reported from local or overseas centres. Multivariate analysis showed that the Child-Pugh class significantly influenced the development of complications and the length of hospital stay, whereas a well-circumscribed tumour margin, the tumour-node-metastasis stage of the tumour, and the Child-Pugh class were independent predictors of survival.
CONCLUSION. Surgical resection for primary liver cancer can be performed with acceptable safety and efficacy in a suitably staffed and equipped private community hospital.
Key words: Carcinoma, hepatocellular/surgery; Hepatectomy; Liver neoplasms/surgery; Postoperative complications
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