42,573 cases of hepatectomy in China: a multicenter retrospective investigation

Sci China Life Sci. 2018 Jun;61(6):660-670. doi: 10.1007/s11427-017-9259-9. Epub 2018 Feb 2.

Abstract

Hepatectomy is currently routinely performed in most hospitals in China. China owns the largest population of liver diseases and the biggest number of liver resection cases. A nationwide multicenter retrospective investigation involving 112 hospitals was performed, and focused on liver resection for patients with hepatocellular carcinoma (HCC). 42,573 cases of hepatectomy were enrolled, and 18,275 valid cases of liver resection for HCC patients were selected for statistical analysis. The epidemiology of HCC, distribution of hepatectomy, postoperative complications and prognosis were finally analyzed. In the 18,275 HCC patients, 81% had hepatitis B virus infection and 10% had hepatitis C virus infection. 38% of the HCC patients had normal Alphafetoprotein (AFP) level, and other 35% had an AFP level lower than 400 ng mL-1. In the study period, 97% of the hepatectomy for HCC were treated with open surgery, and 23.81% had vascular exclusion techniques. The operation time was (191.7±105.6) min, the blood loss was (546.0±562.8) mL, and blood transfusion was (543.0±1,035.2) mL. The median survival for HCC patients was 631 days, with 1-, 3-, and 5-year overall survival of 73.2%, 28.8% and 19.6%, respectively. Liver cirrhosis, multiple nodules, tumor thrombosis and high AFP level were risk factors that affect postoperative survival.

Keywords: China; hepatectomy; hepatocellular carcinoma.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / physiopathology
  • Carcinoma, Hepatocellular / surgery*
  • China / epidemiology
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / statistics & numerical data*
  • Hepatitis, Viral, Human / complications
  • Humans
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / physiopathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / mortality
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • alpha-Fetoproteins / analysis

Substances

  • alpha-Fetoproteins