Surgery for primary liver cancer: A forty years survey

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The authors report the progress of surgery in 3227 patients with pathologically proven primary liver cancer (PLC) over the past four decades (Jan. 1958-Dec. 1997), and the factors improving long-term outcome. The 5-, and 10-year survival after resection of PLC was 44.3% and 33.2%, respectively, for the whole series (n = 2276), and 65.5% and 47.6%, respectively, for patients with small PLC (< = 5cm, n = 861). The 5-year survival after cryosurgery was 39.8% for the whole serias (n = 235), and 55.4% for patients with small PLC (n = 80). The 5-year survival of 93 patients receiving sequential resection after cytoreduction therapy was 64.5%, The 5-year survival after re-resection for recurrence tumor (n = 202) was 35.4% ; 328 patients survived more than 5 years ; 187 of these patients (57.0%) were small PLC, and 109 patients survived more than 10 years. Microwave surgery was used for resectable and unresectable PLC. Encouraging changes in the prognostic pattern were observed when the PLC data 1958-1967 (n = 118), 1968-1977 (n = 356), 1978-1987 (n = 715) and 1988-1997 (n = 2038) were compared ; the 5-year survival being 2.8%, 7.3%, 27.1% and 52.5% respectively, and the 10-year survival being 2.8%, 4.3%, 19.8% and 39.9% respectively. It is concluded that early detection and resection of small PLC is the leading approach to get long-term survivors, cytoreduction and sequential resection might be an important approach to improve the prognosis of patients with unresectable PLC, re-resection for subclinical recurrence and metastasis after an initial curative resection was also important to prolong survival further. Microwave surgery and cytosurgery as minimally invasive therapy have certain advantages in the treatment of PLC.
特定非営利活動法人 Microwave Surgery研究会の論文

Surgery for primary liver cancer: A forty years survey

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