Outcomes and prognostic factors of cirrhotic patients with hepatocellular carcinoma after radical major hepatectomy |
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Authors: | Li Zhou Jing-An Rui Shao-Bin Wang Shu-Guang Chen Qiang Qu Tian-Yi Chi Xue Wei Kai Han Ning Zhang Hai-Tao Zhao |
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Institution: | (1) Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100032, China |
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Abstract: | Background Radical major hepatectomy (RMH) has been suggested as one of main options for cure of large/advanced hepatocellular carcinoma
(HCC). However, its operative risk remains high and its effectiveness is still controversial, especially for patients with
liver cirrhosis. The present study aims to investigate short- and long-term outcomes and to identify prognostic factors for
cirrhotic patients with HCC after RMH.
Materials and Methods Prospectively collected clinicopathological data of 81consecutive cirrhotic HCC patients who underwent RMH were reviewed retrospectively.
The Kaplan-Meier method was adopted for evaluating long-term survival. Prognostic factors were identified by univariate and
multivariate analyses.
Results After RMH, perioperative mortality, overall morbidity, and life-threatening morbidity were 1.2%, 24.7%, and 12.3%, respectively.
Overall and disease-free 5-year survival rates were 39.4% and 28.1%, respectively. Univariate analysis showed that presence
of portal vein tumor thrombosis (PVTT) and satellite nodules, late TNM staging, high Edmondson-Steiner grading, and blood
transfusion was associated with worsened prognosis. Of them, Edmondson-Steiner grading was identified as the sole independent
prognostic factor for both overall and disease-free survival by multivariate analysis, whereas blood transfusion and the presence
of PVTT independently predicted unfavorable overall or disease-free survival, respectively.
Conclusions These data indicated that RMH was safe and appeared to be effective in treating cirrhotic patients with HCC. Some tumor-related
and clinical variables influenced long-term outcome of these patients after RMH. |
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