Of these, however, only vascular invasion was considered to be associated with survival prognosis throughout the entire postoperative period (LF007772 level 2b). Factors for early recurrence, namely, in less than 2 years after surgery, are non-systematic anatomical resection, find more with pathological vascular invasion and AFP of 32 ng/mL or more (LF114293 level 2b). Tumor diameter is also reported to affect
prognosis in some articles (LF006234 level 2b, LF008535 level 4); there is no consensus on this issue. For tumors of 2 cm or less in diameter, the survival rate for patients with early hepatocellular carcinoma is good (LF003786 level 2a). For patients with hepatocellular carcinoma resection accompanied by a tumor thrombosis in the main trunk of the portal vein or the primary branch, prognosis is good for those without ascites, prothrombin activity of 75% or more, and a tumor size of 5 cm or less in diameter (LF106197 level 2b). Of 1481 English original articles (1980–2007) identified using “hepatocellular carcinoma” and “surgery” as key words, 364 concerned prognostic factors. Of these, we reviewed 37 articles
with high reliability. Vascular invasion was most frequently (68%) considered useful, followed by click here liver function (46%), number of tumors (35%), stage classification (19%) and tumor diameter (19%). For liver function, the Child classification and serum albumin levels were often found to be useful. For tumor diameter, 23% of the articles reported that it did not affect prognosis; there is no consensus on this point. Of the stage classes, MCE the survival rate in patients with early hepatocellular carcinoma graded as stage 0 was good; thus, early hepatocellular carcinoma can be defined as a prognostic factor. In addition, some articles reported that presence/absence of capsule, satellite nodule, systematic anatomical resection and AFP level were also significant prognosis factors. In contrast, many articles
stated that presence of cirrhosis and width of the surgical margin were not significant. CQ21 Does width of the surgical margin contribute to prognosis? A minimum surgical margin is sufficient for hepatectomy. (grade B) There was no significant difference in the postoperative recurrence rate between groups with a liver surgical margins of 1 cm or more versus less than 1 cm (LF001281 level 2a, LF007772 level 2b). Comparisons between liver surgical margins of 5 mm or more and less than 5 mm also showed no significant difference in postoperative recurrence rates (LF006233 level 2b, LF007284 level 2b). In addition, a report comparing wide resection (at least lobectomy) and minor resection also showed no significant difference in survival rates (LF000335 level 2b).