| Resection of hepatocellular carcinoma: the effect of surgical margin and blood transfusion on long-term survival. Analysis of 209 consecutive patients. | |
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MedLine Citation:
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PMID: 17629070 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: Certain prognostic factors affect the postoperative mortality and long-term survival of patients following hepatic resection for hepatocellular carcinoma (HCC) and may change the surgical strategy. METHODOLOGY: 209 consecutive patients underwent hepatic resection for HCC in our hospital. Seventy-three patients underwent major resection and 136 underwent minor resections. We looked for correlations between clinical, biological, surgical and pathological factors and postoperative mortality, disease-free survival and overall survival. RESULTS: The postoperative mortality rate was 7.7% (it fell to 0% in the last two years). The cumulative overall five-year survival rate was 27% and the overall disease-free survival rate was 7.3%. Multivariate analysis identified: (1) two independent prognostic factors for postoperative mortality: age and tumor size; (2) one risk factor for tumor recurrence: intraoperative blood transfusion, and (3) three independent prognostic factors for overall survival: infiltrative tumor type, surgical margin <10 mm and intraoperative blood transfusion. CONCLUSIONS: In addition to routine staging of the tumor, the preoperative evaluation of HCC patients should include tests to determine whether the tumor is infiltrative or expansive and whether it will be possible to obtain a surgical margin (>10 mm). This procedure should make it possible to propose an appropriate neoadjuvant treatment only to these patients. The prevention of intraoperative bleeding or blood transfusion should improve the disease-free and overall survival rates in HCC patients. |
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Authors:
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J G Tralhão; S Kayal; I Dagher; M Sanhueza; C Vons; D Franco |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Hepato-gastroenterology Volume: 54 ISSN: 0172-6390 ISO Abbreviation: Hepatogastroenterology Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-07-16 Completed Date: 2007-08-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8007849 Medline TA: Hepatogastroenterology Country: Greece |
Other Details:
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Languages: eng Pagination: 1200-6 Citation Subset: IM |
Affiliation:
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Service de Chirurgie Géndérale, H6pital Antoine Béclère, Facultd de Médecine Paris XI, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Blood Loss, Surgical / prevention & control Blood Transfusion* Carcinoma, Hepatocellular / mortality*, pathology, surgery* Disease-Free Survival Female Hepatectomy Humans Liver Neoplasms / mortality*, pathology, surgery* Male Middle Aged Prognosis Survival Analysis |
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