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Major liver resections for hepatocellular carcinoma on cirrhosis: Early and long‐term outcomes
Author(s) -
Capussotti Lorenzo,
Muratore Andrea,
Massucco Paolo,
Ferrero Alessandro,
Polastri Roberto,
Bouzari Hedayat
Publication year - 2004
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20035
Subject(s) - medicine , hepatocellular carcinoma , cirrhosis , liver function , liver transplantation , survival rate , hepatectomy , surgery , portal vein , mortality rate , milan criteria , gastroenterology , resection , transplantation
Since the lack of donors, liver resections continue to be the treatment of choice for cirrhotic patients with good liver function and resectable hepatocellular carcinoma (HCC). Moreover, over the past 2 decades, an increasing number of major hepatic resections have been performed. The aim of this study is to evaluate short‐ and long‐term outcomes of 55 cirrhotic patients undergoing major hepatic resection with particular attention to the survival of the patients with gross portal vein invasion or large size tumors. Twenty‐two patients (40%) required intra‐ or post‐operative blood transfusion. Medium tumor size was 66.6±29.2 mm; 7 patients had large size (> 10 cm) HCCs. A single node was present in 38 cases (69.1%). There was a gross portal vein tumor thrombus (PVTT) in 13 patients (23.6%). Resection was non‐curative in 4 cases. In‐hospital mortality and morbidity rates were 5.5% and 30.9%, respectively. The overall and disease‐free survival rates were 36.2% and 42.8%, respectively. Overall 5‐year survival rates of patients with large size tumors was 17.1%. Ten patients with a gross PVTT had an R0 resection with a 26.6% 5‐year survival rate. In conclusion, major hepatic resections for HCC can be performed with low mortality and morbidity rates. HCCs with PVTT or greater than 10 cm in size have very limited options of treatment; the favorable long‐term results of our study suggest that they should undergo surgery if a radical resection can be achieved. (Liver Transpl 2004;10:S64–S68.)