Influence of coexisting cirrhosis on outcomes after partial hepatic resection for hepatocellular carcinoma fulfilling the Milan criteria: an analysis of 293 patients.

Influence of coexisting cirrhosis on outcomes after partial hepatic resection for hepatocellular carcinoma fulfilling the Milan criteria: an analysis of 293 patients. Research Abstract Details 

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Influence of coexisting cirrhosis on outcomes after partial hepatic resection for hepatocellular carcinoma fulfilling the Milan criteria: an analysis of 293 patients. Abstract Text:

Kojiro Taura,Iwao Ikai,Etsuro Hatano,Kentaro Yasuchika,Akio Nakajima,Masaharu Tada,Satoru Seo,Takafumi Machimoto,Shinji Uemoto,Kojiro Taura,Iwao Ikai,Etsuro Hatano,Kentaro Yasuchika,Akio Nakajima,Masaharu Tada,Satoru Seo,Takafumi Machimoto,Shinji Uemoto,

BACKGROUND: For patients with liver cirrhosis and hepatocellular carcinoma (HCC) satisfying the Milan criteria (single tumor < or =5 cm or 2 or 3 tumors < or =3 cm), orthotopic liver transplantation (OLT) is an effective treatment. Nevertheless, it remains controversial whether OLT is the best treatment strategy for patients with resectable HCC. METHODS: This study included 293 HCC patients (both with and without cirrhosis) oncologically satisfying the Milan criteria who underwent primary and curative liver resection between 1990 and 2003. RESULTS: There were 127 noncirrhotic, 129 Child-Pugh A cirrhotic, and 37 Child-Pugh B cirrhotic patients. Five-year survival rates in each population were 81%, 54%, and 28%, respectively. Coexisting cirrhosis, Child-Pugh classification, alpha-fetoprotein value, tumor burden, and vascular invasion by the tumor were identified as significant prognostic factors. Among these factors, coexisting cirrhosis was the most crucial variable by multivariate analysis. During the initial 3 postoperative years, yearly tumor recurrence rate was 22% in cirrhotic patients and 15% in noncirrhotic patients. In cirrhotic patients, the recurrence rate did not decrease even after three years of tumor-free survival post-resection, whereas in noncirrhotic patients the recurrence rate decreased to 9%. Cirrhosis was associated with a higher probability of recurrence exceeding the Milan criteria. CONCLUSIONS: Hepatic resection offers an acceptable survival result for HCC patients fulfilling the Milan criteria. Coexisting cirrhosis is associated with higher mortality and recurrence rate, possibly due to multicentric carcinogenesis which limits the efficacy of hepatic resection.

Influence of coexisting cirrhosis on outcomes after partial hepatic resection for hepatocellular carcinoma fulfilling the Milan criteria: an analysis of 293 patients. Publishing Authors By Initials

K Taura,I Ikai,E Hatano,K Yasuchika,A Nakajima,M Tada,S Seo,T Machimoto,S Uemoto,K Taura,I Ikai,E Hatano,K Yasuchika,A Nakajima,M Tada,S Seo,T Machimoto,S Uemoto,

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Influence of coexisting cirrhosis on outcomes after partial hepatic resection for hepatocellular carcinoma fulfilling the Milan criteria: an analysis of 293 patients. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Surgery

VOLUME: 142

Page Numbers: 685-94

Journal Abbreviation: Surgery

ISSN: 0039-6060

DAY: 5

MONTH: Nov

YEAR: 2007

Influence of coexisting cirrhosis on outcomes after partial hepatic resection for hepatocellular carcinoma fulfilling the Milan criteria: an analysis of 293 patients. Information

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LANGUAGE: eng

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AFFILIATION: Department of Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto-city, Kyoto, Japan. ko-taura@air.linkclub.or.jp

Country: United States

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