Background & objective: Weak liver function reserve of hepatocellular carcinoma (HCC) patients with severe cirrhosis lead to high risk of operation. This study was to explore the safety and effects of hepatectomy for HCC patients with severe cirrhosis, and analyze prognostic factors.
Methods: Clinical data of 67 HCC patients with severe cirrhosis, who underwent hepatectomy from 1998 to 2003, were reviewed. The patients were followed up till March 2006. The prognostic factors were studied by univariate and multivariate analysis.
Results: Three patients died after operation. The 1-, 3-, and 5-year cumulative survival rates were 62.6%, 46.7%, and 19.9%, respectively. Univariate analysis showed that Child-Pugh classification, indocyanine green retention rate at 15 min (ICGR15), platelet count, tumor size, number of tumors, and radical resection were significant prognostic factors. Cox multivariate proportional hazard model indicated that Child-Pugh classification and radical resection were independent prognostic factors.
Conclusion: Correct preoperative assessment of liver function reserve can increase the safety of radical surgical resection for HCC patients with severe cirrhosis.