Is There any Benefit from Expanding the Criteria for the Resection of Hepatocellular Carcinoma in Cirrhotic Liver? Experience from a Developing Country

Galun, Danijel; Bulajić, Predrag; Žuvela, Marinko; Basaric, D.; Ille, Tatjana; Milićević, Miroslav

doi:10.1007/s00268-012-1544-x

Cited by 14 publications

(8 citation statements)

References 52 publications

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“…Radiofrequency-assisted sequential “coagulate-cut” liver resection technique was performed in all patients who underwent liver resection. 35 , 36 Type of liver resection was defined according to Brisbane Terminology of liver anatomy and resections. 37 Major liver resection was defined as resection of three or more liver segments.…”

Section: Methodsmentioning

confidence: 99%

Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative-intent surgery for hepatocellular carcinoma: experience from a developing country

Galun¹,

Bogdanović²,

Kovač³

et al. 2018

CMAR

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PurposeThe aim of the study was to evaluate a prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) on long-term survival of cirrhotic and noncirrhotic hepatocellular cancer (HCC) patients managed by a curative-intent liver surgery in a developing country.Patients and methodsDuring the study period between November 1, 2001, and December 31, 2012, 109 patients underwent potentially curative hepatectomy for HCC. Data were retrospectively reviewed from the prospectively collected database. The median follow-up was 25 months. NLR was estimated by dividing an absolute neutrophil count by an absolute lymphocyte count from the differential blood count. Receiver operating characteristic curve was constructed to assess the ability of NLR to predict long-term outcomes and to determine an optimal cutoff value for all patients group, the subgroup with cirrhosis, and the subgroup without cirrhosis. The optimal cutoff values were 1.28, 1.28, and 2.09, respectively.ResultsThe overall 3- and 5-year survival rates were 49% and 45%, respectively, for low NLR group and 38% and 26%, respectively, for high NLR group. The difference was statistically significant (p=0.015). Overall survival was similar between low and high NLR groups in patients with cirrhosis; no difference was found between the groups (p=0.124). In patients without cirrhosis, low NLR group had longer overall survival compared with high NLR group (p=0.015). Univariate analysis identified four factors as significant predictors of long-term survival: cirrhosis, Child-Pugh score, platelet count, and NLR. On multivariate analysis, only platelet count and NLR were independent prognostic factors of long-term survival.ConclusionPrognostic value of NLR was confirmed in noncirrhotic HCC patients who underwent curative-intent liver surgery. In HCC patients with cirrhosis, the prognostic role of NLR was not confirmed.

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Section: Methodsmentioning

confidence: 99%

Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative-intent surgery for hepatocellular carcinoma: experience from a developing country

Galun¹,

Bogdanović²,

Kovač³

et al. 2018

CMAR

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“…At the time of the shortage of liver donors, surgical resection remains a safe option in patients with preserved liver functions. 26,30…”

Section: Discussionmentioning

confidence: 99%

Short-term outcomes after major hepatic resection in patients with cirrhosis: a 75-case unicentric western experience

Chopinet

Grégoire

Bollon

et al. 2019

HPB

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“…In a study by Chen et al [25] the RF-assisted liver resection group showed significantly higher serum AST levels than the CUSA group. Other studies have suggested that radiofrequency-assisted hepatectomy without inflow occlusion can prevent ischemia-reperfusion injury of the remnant of the cirrhotic liver and cause only minor liver injury [15,26] . However, the results of the present study indicate that, during liver resection in patients with cirrhosis, radiofrequency ablation involves more damage to the liver function than the Pringle maneuver.…”

Section: Discussionmentioning

confidence: 99%

Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study

Zhang¹,

Yan²,

Feng³

et al. 2015

WJG

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AIM:To assess the efficiency and safety of radiofrequencyassisted hepatectomy in patients with hepatocellular carcinoma (HCC) and cirrhosis. METHODS:From January 2010 to December 2013, 179 patients with HCC and cirrhosis were recruited for this retrospective study. Of these, 100 patients who received radiofrequency-assisted hepatectomy (RF+ group) were compared to 79 patients who had hepatectomy without ablation (RF-group). The primary endpoint was intraoperative blood loss. The secondary endpoints included liver function, postoperative complications, mortality, and duration of hospital stay. RESULTS:The characteristics of the two groups were closely matched. The Pringle maneuver was not used in the RF+ group. There was significantly less median intraoperative blood loss in the RF+ group (300 vs 400 mL, P = 0.01). On postoperative days (POD) 1 and 5, median alanine aminotransferase was significantly higher in the RF+ group than in the RF-group (POD 1: 348.5 vs 245.5, P = 0.01; POD 5: 112 vs 82.5, P = 0.00), but there was no significant difference between the two groups on POD 3 (260 vs 220, P = 0.24). The median AST was significantly higher in the RF+ group on POD 1 (446 vs 268, P = 0.00), but there was no significant difference between the two groups on POD 3 and 5 (POD 3: 129.5 vs 125, P = 0.65; POD 5: 52.5 Core tip: The purpose of this study was to assess the efficiency and safety of radiofrequency-assisted hepatectomy in patients with hepatocellular carcinoma and cirrhosis. Radiofrequency-assisted hepatectomy can reduce intraoperative blood loss during liver resection effectively. However, this method should be used with caution in patients with concomitant cirrhosis because it may cause severe liver damage and even liver failure.Zhang F, Yan J, Feng XB, Xia F, Li XW, Ma KS, Bie P. Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study.

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Is There any Benefit from Expanding the Criteria for the Resection of Hepatocellular Carcinoma in Cirrhotic Liver? Experience from a Developing Country

Abstract: RF-assisted sequentional "coagulate-cut liver resection technique" may be a viable alternative for management of patients with advanced HCC in cirrhotic liver with impaired function.

Cited by 14 publications

References 52 publications

Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative-intent surgery for hepatocellular carcinoma: experience from a developing country

Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative-intent surgery for hepatocellular carcinoma: experience from a developing country

Short-term outcomes after major hepatic resection in patients with cirrhosis: a 75-case unicentric western experience

Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study

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