Appraisal of surgical resection of XXXX with special reference to hepatic resection.

@entity1 @entity146 @entity344 @entity3 @entity1086
@entity1086 a @entity344 with an extraordinarily poor prognosis. However, @entity146 surgery, with special reference to hepatic resection, may improve survival. To prove this, we performed a retrospective analysis over an 18-year period to investigate the experience of a center that began employing liver resection in @entity1 with @entity1086 in 1978. The analysis was based on @entity1 ' documentation and regular follow-up to January 1996. The standard procedures were extended cholecystectomy (cholecystectomy with lymphadenectomy and wedge hepatic resection), anatomic segmentectomy of segments IVa and V, and extended hepatectomy. Significance was assessed by the log-rank test. Thirty-nine @entity1 were resected, curatively in 41% (n = 22; group I) and palliatively in 31% (n = 17; group 2). In 28% (n = 15; group 3) a palliative or no operation was performed. Only curatively resected @entity1 were analyzed and followed up to January 1996. No @entity1 in group 1 died postoperatively. The actuarial 5-year survival rate of the @entity1 with curative resection was 55%. Four @entity1 had stage I, two had stage II, four had stage III, and two had stage IV disease according to TNM-classification. Six of the 16 @entity1 without lymph node @entity3 survived more than 5 years. A significant difference in long-term survival was recognised between stage II and stage IV @entity1 and between stage (pT1a)- and (look table 1b) (pT1b)- @entity1 (P < 0.01). Diagnostic efforts should focus on detecting early stages I and II @entity1086 . In advanced cases, @entity146 surgery, particularly with hepatic resection, is the method of choice and is successful even in @entity1 70 years and older.
