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汤钊猷

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期刊论文

subclinical hepatocellular carcinoma: an analysis of 391 patients

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journal of surgical oncology supplement 3: 55-58 (1993),-0001,():

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摘要/描述

subclinical hepatocellular carcinoma (schcc) is defined as hcc without obvious hcc symptoms and signs. during 1958-1991, 391 patients with schcc were analyzed. in the entire series, 1) 67.3% was detected by natural population sereening using alpha-fetoprotein (afp) serosurvey, while the others were discovered by high-risk population screening or regular health checkup using afp and/or ultrasonography (us); 2) afp>20 ug/l was found in 77.6% of patients; 3) serum hepatitis b surface antigen (hbsag) was positive in 68.9; 4) associated liver cirrho-sis occurred in 89.1%; 5) the median tumor size was 5 cm, and limited resection was performed in the majority (71.3%); 7) re-resection for sub-clinical recurrence was done in 44 patients; and 8) cytoreduction and sequential resection was carried out in 13 patients with unresectable schcc. comparison between schcc and clinical hcc (n=1, 251) revealed higher resectability(81.4% vs, 46.8%), lower operative mortality (1.9% vs. 6.0%), and higher 5-year survival (entire series; 50.7% vs. 20.6%; resection: 60.5% vs. 36.8%). it is concluded that the study of schcc has resulted in marked improvement of ultimate outcome of hcc; screening in high-risk populations using afp and/or us, limited resection, and re-resection for subclinical recurrence are some of the key features.

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