Hepatic resection in cirrhotic liver for treatment of hepatocellular carcinoma in Egyptian patients. Experience with 140 cases in a single center.

Background/Aims: In many centers hepatic resection is still the treatment of choice for hepatocellular carcinoma in cirrhotic liver. Serveral factors affect the prognosis; one of them is the extent of resection. This study retrospectively evaluates outcome after different types of hepatic resection in cirrhotic liver. Methodology: Hepatectomy was performed in 245 patients. From them, 140 patients were sufjected to hepatic resection for hepatocellular carcinoma in cirrhotic liver. According to the type of resection the patients were divided into three groups (A, B and C), major resection, (group A) in 79 (56.3%), segmental resection (group B) 31 (22.1%) and localized resection (group C) in 30 (21.4%). Early postoperative mortality and morbidity as well as long-term survival and recurrence were assessed. Results: The overall hospital mortality rate was (8.6%) with total complication 26%, recurrence rate 32.8% and median survival was 24 months (3-120). Group A showed high incidence rate of bospital mortality. total complications and hepatic cell failure than the other two types (p>0.05). On teh other hand, group C patients showed high incidence of wund infection and recurrence rate after hepatic resection than the other two types (p>0.05). At the end of the study, the median survival was 18 months (4-120). 24 months (3-48) and 24 months (3-120) for the three groups respectively without significat chfference. The overall 5-year survival rate was 20%, 0% and 15.3% for the three groups respectively (p>0.05). Conclusions: Although major liver resection in cirrhotic liver has high incidence of early mortality and morbidity, it gives low incidence of recurrenme and better survival in comparison with segmental and localized resection. However it has to be reserved for large tumor in good liver and early cirrhosis.