Document Detail


Liver resection for hepatocellular carcinoma in a hepatitis B endemic area.
MedLine Citation:
PMID:  17610112     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. Treatment options include liver resection, tumor ablation, and liver transplantation. METHODS: We report the results of all patients undergoing partial hepatectomy for HCC with curative intent from a center where all major treatment modalities were available. RESULTS: A series of 53 patients were identified, of whom 72% had underlying liver disease, mostly chronic hepatitis B infection. Altogether, 57% of patients underwent major resections, of whom 43% had histologically proven cirrhosis. Postoperative morbidity and mortality occurred in 41.5% and 7.5%, respectively. After a median follow-up of 34 months, the survival probabilities at 1, 3, and 5 years were 74.1%, 54.1%, and 42.6%, respectively. A total of 47% developed recurrent disease over the study period with a median disease-free survival of 13.8 months. The probabilities of recurrence at 1, 3, and 5 years were 35.2%, 49.4%, and 55.9%, respectively. Among those who developed recurrence, 76% died, with a median time to death from the time the recurrence was diagnosed of 7.8 months. There was a good association between the CLIP score and survival following liver resection. Multivariate analysis showed that only tumor recurrence and the presence of cirrhosis was a significant determinant of the risk of tumor-related death. CONCLUSION: These findings confirm that with careful patient selection liver resection for HCC can achieve good long-term patient survival and acceptable risks.
Authors:
Adam St J R Bartlett; John L McCall; Jonathan B Koea; Andrew Holden; Mee-Ling Yeong; Nishanthi Gurusinghe; Ed Gane
Publication Detail:
Type:  Journal Article     Date:  2007-07-04
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-20     Completed Date:  2007-12-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1775-81     Citation Subset:  IM    
Affiliation:
Department of Hepatobiliary and Transplant Surgery, New Zealand Liver Transplant Unit, Level 15, Support Building, Auckland City Hospital, Park Road, Grafton, Auckland, New Zealand.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular / epidemiology,  surgery*,  virology
Child
Female
Follow-Up Studies
Hepatectomy*
Hepatitis B, Chronic / complications*
Humans
Liver Neoplasms / epidemiology,  surgery*,  virology
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local* / surgery
New Zealand / epidemiology
Prospective Studies
Risk Factors
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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