切除し得た肝細胞性肝癌30例の臨床病理学的研究--特に予後因子について

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During the past 13 years, from 1965 to 1978, we have examined 30 resectable cases of hepatocellular carcinoma in the First Department of Surgery, Kyoto University Hospital. Operative mortality was 20% (6/30). Nineteen cases of hepatocellular carcinoma with cirrhosis and 11 cases of hepatocellular carcinoma without cirrhosis were subjected to pathological and surgical examination. Of the 21 cases which occured in the right lobe, 4 underwent extended right hepatectomy, 6 right hepatectomy and 11 right partial hepatectomy. Of the 9 cases which occurred in the left lobe, 6 left hepatectomy and 3 left lateral segmentectomy.<BR>There is not a definite correlation between a tumor occupied region and it's prognosis. We determined that a remnant liver has a regenerative capacity by measuring OGTT and mitochondrial function; our operative mortality and mean Survival did not take cirrhosis into account.<BR>We proposed that R.D. (-) represented over 3 cm of R.D., which we called the macroscopic space between the resection wall and the tumor edge. The mean survival in 11 cases of RD. (-) and l3 cases of R.D. (+) were 3 years 9 months and about 1 year, respectively. Twenty cases were encapsulated tumor and 6 cases were not. The former had 2 years 8.3 months in mean survival, and the latter 7.1 months. If the tumor had R.D. (-) and encapsulation, it would have a good prognosis.<BR>A.F.P. producdon did not relate to prognosis, but the hitological differentiation of hepatocellular carcinoma correlated to prognosis, that is, better prognosis could be seen among the well or moderately differentiated hepatocellular carcinoma than among the poorly differentiated or undifferentiated hepatocellular carcinoma. It is suggested that the important prognostic factors on TeSected hepatocellular carcinoma may be affected by resection distance (R.D.), encapsulatioh and histological differentiation.
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切除し得た肝細胞性肝癌30例の臨床病理学的研究--特に予後因子について

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