Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl

PL EN


Preferences help
enabled [disable] Abstract
Number of results
2011 | 83 | 6 | 319-324

Article title

Long-Term Results of Liver Resection in the Treatment of Patients with Hepatocellular Carcinoma

Content

Title variants

Languages of publication

EN

Abstracts

EN
The aim of the study was the analysis of the results of liver resection in the treatment of patients with hepatocellular carcinoma, taking into consideration the selected factors based on the department's material.Material and methods. Data of 122 patients subject to liver resection due to hepatocellular carcinoma at the Department of General, Transplantation and Liver Surgery, Medical University of Warsaw, were subject to retrospective analysis.The influence of selected factors on the long-term treatment results was determined, and the patient survival depending on the tumor stage as per the TNM scale was compared. The statistical significance threshold was set at p = 0.05.Results. 1- and 3-year overall survival and recurrence-free survival in the whole patient group was 82.1% and 56.3%, and 57.7% and 20.1%, respectively. The perioperative mortality rate was 1.6%. The neoplasm advancement exceeding the first stage on the TNM scale was associated with lower values of overall survival (p = 0.001, HR = 3.7) and recurrence-free survival (p = 0.00008, HR = 3.8). Elevation of AFP was the only independent prognostic factor for overall survival (p = 0.04, HR = 1.04 at alpha-fetoprotein levels > 1000 ng/ml), while the presence of neoplastic emboli in small blood vessels was an independent risk factor for HCC recurrence (p = 0.02, HR = 2.24).Conclusions. The alpha-fetoprotein levels and presence in the histopathological examination of neoplastic emboli in small blood vessels are independent prognostic factors for outcome of patients operated for hepatocellular carcinoma. The diagnosis of neoplasm at stage 1 as per TNM significantly improves long-term results of resective treatment.

Publisher

Year

Volume

83

Issue

6

Pages

319-324

Physical description

Dates

published
1 - 6 - 2011
online
25 - 7 - 2011

Contributors

author
  • Chair and Department of General, Transplant and Liver Surgery, Medical University of Warsaw
  • Chair and Department of General, Transplant and Liver Surgery, Medical University of Warsaw
  • Chair and Department of General, Transplant and Liver Surgery, Medical University of Warsaw
  • Chair and Department of General, Transplant and Liver Surgery, Medical University of Warsaw
  • Chair and Department of General, Transplant and Liver Surgery, Medical University of Warsaw

References

  • Krawczyk M: Hepatocellular carcinoma. Med Sci Rev Hepatol 2008; 8: 92-99.
  • Benvegnu L, Gios M, Boccato S et al.: Natural history of compensated viral cirrhosis: a prospective study on the incidence and hierarchy of major complications. Gut 2004; 53: 744-49.[Crossref]
  • Sangiovanni A, Del Ninno E, Fasani P et al.: Increased survival of cirrhotic patients with a hepatocellular carcinoma detected during surveillance. Gastroenterology 2004; 126: 1005-14.
  • Ioannou GN, Splan MF, Weiss NS et al.: Incidence and Predictors of Hepatocellular Carcinoma in Patients With Cirrhosis. Clin Gastroenterol Hepatol 2007; 5: 938-45.[Crossref]
  • Simonetti RG, Camma C, Fiorello F et al.: Hepatocellular carcinoma. A worldwide problem and the major risk factors. Dig Dis Sci 1991; 36: 962-72.[PubMed][Crossref]
  • Belghiti J: Resection and liver transplantation for HCC. J Gastroenterol 2009; 44: 132-35.[Crossref][PubMed]
  • Baccarani U, Benzoni E, Adani GL et al.: Superiority of Transplantation Versus Resection for the Treatment of Small Hepatocellular Carcinoma. Transplant Proc 2007; 39: 1898-1900.[Crossref]
  • Mazzaferro V, Regalia E, Doci R et al.: Liver transplantation for the treatment of small hepatocellular carcinoma in patients with cirrhosis. N Engl J Med 1996; 334: 693-99.
  • Rayya F, Harms J, Bartels M et al.: Results of Resection and Transplantation for Hepatocellular Carcinoma in Cirrhosis and Noncirrhosis. Transplant Proc 2008; 40: 933-35.[Crossref]
  • Facciuto ME, Koneru B, Rocca JP et al.: Surgical Treatment of Hepatocellular Carcinoma beyond Milan Criteria. Results of Liver Resection, Salvage Transplantation, and Primary Liver Transplantation. Ann Surg Onc 2008; 15: 1383-91.[Crossref]
  • Vennarecci G, Ettorre GM, Antonini M et al.: First-Line Liver Resection and Salvage Liver Transplantation Are Increasing Therapeutic Strategies for Patients With Hepatocellular Carcinoma and Child A Cirrhosis. Transplant Proc 2007; 39: 1857-60.[Crossref]
  • Poon RTP: Optimal Initial Treatment for Early Hepatocellular Carcinoma in Patients with Preserved Liver Function: Transplantation or Resection? Ann Surg Onc 2006; 14: 541-47.
  • Timm S, Sotiropoulos GC, Draier M et al.: Selective Transarterial Chemoembolization of Advanced Hepatocellular Carcinomas: A Reasonable Palliative Option. Transplant Proc 2008; 40: 3179-81.[Crossref][WoS]
  • Llovet JM, Ricci S, Mazzaferro V et al.: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359: 378-90.
  • Helton SW, Di Bisceglie A, Chari R et al.: Treatment Strategies for Hepatocellular Carcinoma in Cirrhosis. J Gastrointestinal Surg 2003; 7: 401-11.[Crossref]
  • Taura N, Hamasaki K, Nakao K et al.: The Impact of Newer Treatment Modalities on Survival in Patients With Hepatocellular Carcinoma. Clin Gastroenterol Hepatol 2006; 4: 1177-83.[Crossref][PubMed]
  • Virani S, Michaelson JS, Hutter MM et al.: Morbidity and Mortality after Liver Resection: Results of the Patients Safety in Surgery Study. J Am Coll Surg 2007; 204: 1284-92.
  • Ferrero A, Polastri R, Muratore A et al.: Extensive Resections for colorectal liver metastases. J Hepatobiliary Pancreat Surg 2004; 11: 92-96.[Crossref]
  • Benzoni E, Cojutti A, Lorenzin D et al.: Liver resective surgery: a multivariate analysis of postoperative outcome and complication. Langenbecks Arch Surg 2007; 392: 45-54.[WoS]
  • Sherman M: The resurrection of alphafetoprotein. J Hepatol 2010; 52: 939-40.[PubMed][Crossref][WoS]
  • Hanazaki K, Kajikawa S, Koide N et al.: Prognostic factors after hepatic resection for hepatocellular carcinoma with hepatitis C viral infection: univariate and multivariate analysis. Am J Gastroenterol 2001; 96: 1243-50.
  • Wakai T, Shirai Y, Sakata J et al.: Anatomic Resection Independently Improves Long-Term Survival in Patients with T1-T2 Hepatocellular Carcinoma. Ann Surg Oncol 2007; 14: 1356-65.[Crossref]
  • Hasegawa K, Kokudo N, Imamura H et al.: Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg 2005; 242: 252-59.
  • Tanaka K, Shimada H, Matsumoto C et al.: Anatomic versus limited nonanatomic resection for solitary hepatocellular carcinoma. Surgery 2008; 143: 607-15.
  • Kang CM, Choi GH, Kim DH et al.: Revisiting the role of nonanatomic resection of small (< or = 4 cm) and single hepatocellular carcinoma in patients with well-preserved liver function. J Surg Res 2010; 160: 81-89.[WoS]

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_v10035-011-0049-x
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.