Long-Term Results of Hepatic Resection Combined with Intraoperative Local Ablation Therapy for Patients with Multinodular Hepatocellular Carcinomas

Background Recently, local ablation therapy has been widely used for treatment of small hepatocellular carcinoma (HCC). The present study assessed the outcome of hepatic resection combined with intraoperative local ablation therapy in patients with multinodular HCCs. Methods Forty-one patients with initial and multinodular HCCs underwent hepatic resection combined with intraoperative local ablation therapy. The mean maximum diameter of all tumors was 3.8 cm (range 2.1–16.0 cm), and the mean number of nodules was 3.2 (range 2–11). We evaluated the survival rates and assessed the prognostic factors associated with overall survival rates using Cox proportional hazard models. Results Intraoperative local ablation therapy was completed in all patients with no evidence of residual viable tumor on the first postoperative computed tomography (CT) scan. The 3-, 5- and 7-year overall survival rates were 84.3%, 61.2%, and 61.2%, respectively. Patients with preoperative des-gamma carboxyprothrombin (DCP) level >300 mAU/ml showed significantly worse overall survival than those with DCP level ≤300 mAU/ml ( P 300 mAU/ml was a significant prognostic factor of long-term overall survival.