Hepatocellular carcinoma. Results of partial hepatectomy and analysis of prognostic factors. São Paulo, 1999. 152 p. Thesis (Doutorado) - Faculdade de Medicina. Universidade de São Paulo. Texto completo em pdf - portuguese (933Kb).


Hepatocellular carcinoma is one of the most frequent cancer worldwide. Between 1974 and 1995, 126 patients underwent liver resection for this reason. The records were retrospectively studied to determine the prognostic factors influencing operative mortality, recurrence and long term survival. Overall operative mortality was 11.1%. Morbidity was 31.7%. Resectability rate was 60.8%. Postoperative complication and mortality were related to liver failure. Statistical analysis of possible prognostic factors revealed that patients with decreased liver function reserve, with prolonged liver ischemia and operated on between 1974 and 1986 presented higher risk for postoperative mortality. Patients with high level of alpha-fetoprotein and surgical margin less than 1 cm presented early recurrence and lower survival rate. Multivariate analysis also revealed as prognostic factors for survival: presence of symptoms, presence of three or more tumors, Okuda 2 and 3 classification, major resection and prolonged liver ischemia. We concluded that early detection and preoperative evaluation of liver function reserve will improve the surgical results.