Prognostic Factors of 10-Year Survivors after Initial Treatment for Hepatocellular Carcinoma, Determined in 713 Japanese Patients in Relation to Indication of Liver Transplantation.

Purpose: To clarify the prognostic factors for long-term survival by studying the clinical factors of 10-year survivors after initial treatment for hepatocellular carcinoma (HCC). Methods: 713 Japanese patients who had received over 10 year’s observation after initial treatment for HCC were selected. Differences in clinical factors between 10-year survivors and the remainder were studied. The multiple logistic regression model was used for multivariate analysis. Results: Significant differences were noted between the groups in age, tumor number, vascular involvement, concordance of Milan Criteria (MC), Japanese tumor-node-metastasis stage, Child-Pugh stage (CP), HCV infection, serum α-fetoprotein level, and modality of initial treatment. Multivariate analysis showed that older age, out of MC, CP-B or -C, and initially treated other than by hepatectomy were independent risk factors for 10-year survival. If patients were within MC and CP-A, the overall 10-year survival rate of those initially treated by hepatectomy was 71%, and 49% for those with HCV infection. Conclusions: Younger patients with initial HCC within MC and CP-A can expect long-term sur vival, if surgically resectable. Hepatectomy should be considered especially to HCC patients with HCV infection, if in these categories.