Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

The Changes of Clinical Pattern of Patients Who Underwent Hepatectomies for Hepatocellular Carcinoma according to Chronological Periods

간세포암 절제술을 시행받은 환자의 시대별 임상양상의 변화

  • Yang, Hoe-Min (Department of Surgery, Korea Cancer Center Hospital) ;
  • Kim, Sang-Bum (Department of Surgery, Korea Cancer Center Hospital) ;
  • Cho, Eung-Ho (Department of Surgery, Korea Cancer Center Hospital) ;
  • Choi, Dong-Wook (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 양회민 (한국 원자력의학원 외과) ;
  • 김상범 (한국 원자력의학원 외과) ;
  • 조응호 (한국 원자력의학원 외과) ;
  • 최동욱 (성균관대학교 의과대학 삼성서울병원 외과학교실)
  • Published : 2010.06.30
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Abstract

Purpose: The purpose of this study was to identify changes over several years in clinical patterns of patients who underwent hepatectomies for HCC. Methods: There were 502 patients who underwent hepatectomies for HCC between January 1986 and July 2009 at the Korea Cancer Center Hospital, Seoul, Korea. Period 1 (n=206) extended from the beginning to December 2000. Period 2 from January 2001 to December 2004 (n=146). Period 3 from January 2005 to July 2009 (n=150). The data for the different periods were compared retrospectively or prospectively. Results: Compared to patients from Period 1, Period 2 and Period 3 patients had operations >6 months from diagnosis (p=0.002), high levels of preoperative AST and ALT (p<0.001), and poor scores on the ICG R15 test (p=0.047). The Frequency of Transfusion during the operation was decreased (p<0.001), but there was no difference in postoperative complication rates (p=0.403). In Periods 2 and 3, there was a higher frequency of multiple tumors (p<0.001) and microvascular invasions histologically (p<0.001). Differences between periods in disease free survival rates were not significant. Conclusion: The reason for the higher frequency, in more recent periods, of patients presenting at surgery with advanced HCC stages is the longer interval between diagnosis and operative time, and an increase in the number of non-surgical treatments before surgery. Because of differences in follow-up intervals, it was difficult to evaluate the influence of period on survival rates. Hence, a longer follow-up period will be required for an accurate evaluation of changes in survival with time.

Keywords

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