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Surgery for small liver cancers
Abstract
During the last 16 years, we have resected small hepatocellular carcinomas (HCCs) measuring 5 cm or less from 362 patients, 266 of whom also had liver cirrhosis. The operative and hospital mortality rate were 1.7% and 1.9%, respectively. These showed a gradual decrease year by year in parallel with reduction of intraoperative blood loss achieved by the selective vascular occlusion technique and Pringle method. In 1989, 87% of hepatectomy patients were discharged without the need for whole blood transfusion, and 5‐year survival was 43.7%. Tumor size, number of tumors, intrahepatic metastasis, vascular invasion, and capsular invasion were significant prognostic factors. Edmondson grade and the operative procedure employed were significantly related to outcome. Our standard policy for selection of operative procedures and perioperative care is described, and the selection of treatment modalities is discussed.
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Citations
Cited by
EASL–EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma
European Association for the Study of the Liver, & European Organisation for Research and Treatment of Cancer (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2011.12.001 · Cited by 5,218
“The refinement of assessment of liver function has moved from the gross determination of Child–Pugh class to a more sophisticated measurement of indocyanine green retention rate at 15 min (ICG15) [186] or hepatic venous pressure gradient (HVPG) P10 mmHg as a direct measurement of relevant portal hypertension [187].”
BackgroundEASL Clinical Practice Guidelines on the management of hepatocellular carcinoma
Sangro, B., Argemi, J., Ronot, M., Paradis, V., Meyer, T., Mazzaferro, V., Jepsen, P., Golfieri, R., Galle, P., Dawson, L., et al. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2024.08.028 · Cited by 985
One Thousand Fifty-Six Hepatectomies Without Mortality in 8 Years
Imamura, H. (2003) · Archives of Surgery · doi:10.1001/archsurg.138.11.1198 · Cited by 835
Lin, S.-M., Lin, C.-J., Lin, C.-C., Hsu, C.-W., & Chen, Y.-C. (2005) · Gut · doi:10.1136/gut.2004.045203 · Cited by 592
Torzilli, G. (1999) · Archives of Surgery · doi:10.1001/archsurg.134.9.984 · Cited by 455
Metadata
- Authors
- Makuuchi, M., Kosuge, T., Takayama, T., Yamazaki, S., Kakazu, T., Miyagawa, S., & Kawasaki, S.
- Venue
- Seminars in Surgical Oncology
- Publisher
- Wiley
- Published
- 1993-07
- Volume
- 9
- Issue
- 4
- Pages
- 298-304
- ISSN
- 1098-2388 (ISSN-L)
- 8756-0437
- OpenAlex
- W2078804815
- Cited by
- 790
- References
- 0
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Surgery for small liver cancers. https://app.cochat.ai/papers/10.1002/ssu.2980090404
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- Makuuchi, M., Kosuge, T., Takayama, T., Yamazaki, S., Kakazu, T., Miyagawa, S., & Kawasaki, S. (1993). Surgery for small liver cancers. Seminars in Surgical Oncology. https://doi.org/10.1002/ssu.2980090404
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