Hepatic Resection for Hepatocellular Carcinoma Meeting Milan Criteria in Child-Turcotte-Pugh Class A Patients With Cirrhosis

Park, Y.-K.; Kim, B.-W.; Wang, H.-J.; Kim, M.-W.

doi:10.1016/j.transproceed.2008.07.146

Cited by 37 publications

(28 citation statements)

References 34 publications

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“…In addition, our results regarding the estimated 5-year survival rate were similar to those in previous surgical studies in which the reported 5-year survival rates were between 34.4% and 70.0% (27)(28)(29)(30)(31)(32)(33). Furthermore, if we analyze the results of RFA in 47 patients who met the BCLC criteria for resection, the 5-year overall survival rate reached 81.8%, which is even better than that reported in other studies that included patients who were treated with either RFA or hepatic resection (3,4,11,26,34).…”

Section: Discussionsupporting

confidence: 90%

Radiofrequency Ablation of Hepatocellular Carcinoma as First-Line Treatment: Long-term Results and Prognostic Factors in 162 Patients with Cirrhosis

Lee¹,

Lee²,

Lee³

et al. 2014

Radiology

279

216

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Section: Discussionsupporting

confidence: 90%

Radiofrequency Ablation of Hepatocellular Carcinoma as First-Line Treatment: Long-term Results and Prognostic Factors in 162 Patients with Cirrhosis

Lee¹,

Lee²,

Lee³

et al. 2014

Radiology

279

216

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“…It has been generally confirmed that certain clinicopathological data including tumor multiplicity, large tumor size and vascular invasion are poor prognostic indicators and risk factors for early recurrence of HCC (15)(16)(17)(18)(19). Previously, we reported that the mathematical product of tumor number and size of largest tumor (NxS factor) could be a comprehensive measure of tumor burden to predict the prognosis of HCC patients who underwent liver resection, especially for predicting disease-free survival (20,21).…”

Section: Introductionmentioning

confidence: 90%

A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

et al. 2018

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Abstract. We previously reported the effectiveness of the product of tumor number and size (NxS factor) for the prognosis of hepatocellular carcinoma (HCC) in patients following hepatectomy. The present study aimed to propose a new score based on the NxS factor to predict HCC recurrence following hepatectomy. A total of 406 patients who underwent hepatectomy for HCC at Osaka University Graduate School of Medicine were retrospectively analyzed to develop the new score. Among clinicopathological factors, including the NxS factor, the marker subset that achieved the best performance for prediction of early recurrence was assessed, and a prognostic model for HCC recurrence after curative hepatectomy (REACH) was developed. As the validation set, 425 patients who underwent hepatectomy for HCC at Yamaguchi University Graduate School of Medicine and Shimonoseki Medical Center were analyzed, and the prognostic ability of the REACH score was compared with that of well-known staging systems. Following analysis, the REACH score was constructed using six covariates (NxS factor, microscopic hepatic vein invasion, differentiation, serum albumin, platelet count and indocyanine green retention rate at 15 min). In the validation set, the REACH score predicted early recurrence in 73 of 81 samples, with a sensitivity of 89% and a specificity of 58%. The area under the curve (AUC) of the receiver operating characteristic curve of the REACH score was 0.78 and 0.74, respectively, for 1-and 2-year recurrence after hepatectomy; each AUC was higher than that of any of the other staging systems. Survival analysis indicated the REACH score had the best predictive value in disease-free and overall survival. The present findings demonstrated that the REACH score may be used to classify patients with HCC into high-and low-risk of recurrence, and to predict subsequent survival following hepatic resection.

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“…The outcome of partial hepatectomy in cirrhotic patients has improved remarkably in recent years with improved surgical techniques and perioperative care (7,8): mortality is reported to range between 0% and 5% in tertiary centers and postoperative hepatic decompensation to be about 4% (8,(20)(21)(22) (20,(24)(25)(26). Regarding transplantability of HCC recurrence, the literature reports that tumor recurrence suitable for salvage transplantation occurs with a median of 60%, ranging from 23% to 89% (20,22,(27)(28)(29)(30).…”

Section: Variables Considered After Hrmentioning

confidence: 99%

“…Regarding transplantability of HCC recurrence, the literature reports that tumor recurrence suitable for salvage transplantation occurs with a median of 60%, ranging from 23% to 89% (20,22,(27)(28)(29)(30).…”

Section: Variables Considered After Hrmentioning

confidence: 99%

Harm and Benefits of Primary Liver Resection and Salvage Transplantation for Hepatocellular Carcinoma

Cucchetti

Vitale

Gaudio

et al. 2010

American Journal of Transplantation

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Primary transplantation offers longer life-expectancy in comparison to hepatic resection (HR) for hepatocellular carcinoma (HCC) followed by salvage transplantation; however, livers not used for primary transplantation can be reallocated to the remaining waiting-list patients, thus, the harm caused to resected patients could be balanced, or outweighed, by the benefit obtained from reallocation of livers originating from HCC patients first being resected. A Markov model was developed to investigate this issue based on literature data or estimated from the United Network for Organ Sharing database. Markov model shows that primary transplantation offers longer life-expectancy in comparison to HR and salvage transplantation if 5-year posttransplant survival remains higher than 60%. The balance between the harm for resected patients and the benefit for the remaining waiting list depends on (a) the proportion of HCC candidates, (b) the percentage shifted to HR and (c) the median expected time-to-transplant. Faced with a low proportion of HCC candidates, the harm caused to resected patients was higher than the benefit that could be obtained for the waiting-list population from re-allocation of extra livers. An increased proportion of HCC candidates and/or an increased median time-to-transplant could lead to a benefit for waiting-list patients that outweighs this harm.

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Hepatic Resection for Hepatocellular Carcinoma Meeting Milan Criteria in Child-Turcotte-Pugh Class A Patients With Cirrhosis

Cited by 37 publications

References 34 publications

Radiofrequency Ablation of Hepatocellular Carcinoma as First-Line Treatment: Long-term Results and Prognostic Factors in 162 Patients with Cirrhosis

Radiofrequency Ablation of Hepatocellular Carcinoma as First-Line Treatment: Long-term Results and Prognostic Factors in 162 Patients with Cirrhosis

A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

Harm and Benefits of Primary Liver Resection and Salvage Transplantation for Hepatocellular Carcinoma

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