Predictive factors for long term prognosis after partial hepatectomy for patients with hepatocellular carcinoma in Japan. The Liver Cancer Study Group of Japan.

Great progress in the diagnosis and surgical treatment of hepatocellular carcinoma (HCC) has led to an increased number of resectable cases. Much attention has been paid to the factors affecting long term survival of patients with HCC after partial hepatectomy. Survival rates for approximately 5800 patients with HCC registered by the Liver Cancer Study Group of Japan who received partial hepatic resection from January 1, 1982 to December 31, 1989 were calculated relative to 14 clinicopathologic variables. Cox's multivariate analysis and the stepwise method then were performed to determine significant prognostic variables and to investigate the appropriate combination of these variables for predicting prognosis. The use of Cox's multivariate proportional hazard model indicated that significant prognostic indicators were alpha-fetoprotein level, tumor size, number of tumors, accompanying cirrhosis, age, surgical curability, and portal involvement. The stepwise method showed that the most valuable prognostic factor was portal involvement, followed by number of tumors, alpha-fetoprotein level, tumor size, accompanying cirrhosis, age, and surgical curability. Furthermore, it was found that the best predictive combination of two factors was number of tumors and alpha-fetoprotein level and that the best predictive combination of three factors was the alpha-fetoprotein level, tumor size, and number of tumors. This extensive analysis provides information that can be used to predict the prognosis of patients with HCC after undergoing partial hepatectomy.