Liver #resection of #hepatocellular carcinoma in patients with portal #hypertension and multiple tumors
http://onlinelibrary.wiley.com/doi/10.1111/hepr.13047/abstract
Liver resection for hepatocellular carcinoma (HCC) has been recommended only for patients with a single tumor without portal hypertension. We aimed to validate this treatment strategy that is based on by the Barcelona Clinic Liver Cancer staging system The median overall and recurrence-free survival periods of patients in Group 1 (N= 695) were 8.5 years (95% confidence interval CI 6.6−9.0) and 2.4 years (2.2−2.7), respectively, and were significantly longer compared with those of patients in Group 2 (N = 197) (5.6 years 95% CI, 4.8−6.7, P = 0.001, and 1.9 years 1.6−2.1, P < 0.001). On multivariate analysis, the independent factors for overall survival were hepatitis C virus infection (HR 1.29 95% CI, 1.02−1.65, P = 0.032), multiple tumors (1.42 1.01−1.98, P = 0.040), and vascular invasion (1.66 1.31−2.10, P < 0.001). On the other hand, frequency of morbidities (23 3.3% patients vs 11 5.5% patients, P = 0.143) and mortalities (3 0.4% patients vs 2 1.0% patients, P = 0.305) was not significantly different between the two groups.
Conclusions
Patients with HCC with portal hypertension and/or multiple tumors could be the candidates for liver resection due to the safety of the procedure
http://onlinelibrary.wiley.com/doi/10.1111/hepr.13047/abstract
Liver resection for hepatocellular carcinoma (HCC) has been recommended only for patients with a single tumor without portal hypertension. We aimed to validate this treatment strategy that is based on by the Barcelona Clinic Liver Cancer staging system The median overall and recurrence-free survival periods of patients in Group 1 (N= 695) were 8.5 years (95% confidence interval CI 6.6−9.0) and 2.4 years (2.2−2.7), respectively, and were significantly longer compared with those of patients in Group 2 (N = 197) (5.6 years 95% CI, 4.8−6.7, P = 0.001, and 1.9 years 1.6−2.1, P < 0.001). On multivariate analysis, the independent factors for overall survival were hepatitis C virus infection (HR 1.29 95% CI, 1.02−1.65, P = 0.032), multiple tumors (1.42 1.01−1.98, P = 0.040), and vascular invasion (1.66 1.31−2.10, P < 0.001). On the other hand, frequency of morbidities (23 3.3% patients vs 11 5.5% patients, P = 0.143) and mortalities (3 0.4% patients vs 2 1.0% patients, P = 0.305) was not significantly different between the two groups.
Conclusions
Patients with HCC with portal hypertension and/or multiple tumors could be the candidates for liver resection due to the safety of the procedure