Sequential resection after cytoreduction of unresectable hepatocellular carcinoma and factors influencing survival of patients

Objective To study the therapeutic effects of hepatic resection on shrunk hepatocel- lular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE)and investigate factors influencing the survival of patients with unresectable HCC.Methods A total of 112 patients with un- resectable HCC received TACE for 1～7 courses(mean=2.4±1.2 courses).Then the shrunk tumors were surgically removed by two-stage operation in all the patients.Seven possible factors influ- encing the outcome of sequential resection of HCC were studied by univariate and Cox multivariate a nalysis.All patients were followed up until December 2000.Results After resection of the shrunk tumors,the 1-,3-,5- and 7-year survival rates were 94.1%,64.7%,51.2% and 40.8%,respec- tively.No matter whether the capsule of the shrunk tumor was complete or not,the extent of cirrhotic liver and percentages of tumor necrosis were of prognostic significance.Conclusions Sequential resec- tion should be performed after cytoreduction of the tumor in patients with unresectable HCC because it can improve survival of the patients.No matter whether the capsule of the shrunk tumor was complete or not,the extent of cirrhotic liver and percentages of tumor necrosis are the major factors influencing the survival of patients after two-stage operation.