Liver resection for hepatocellular carcinoma in patients without cirrhosis

Abstract

Background: Data on liver resection for hepatocellular carcinoma (HCC) without cirrhosis are sparse. The present study was conducted to evaluate the indications and results of liver resection for HCC with regard to safety and efficacy.Methods: Data for patients who had liver resection for HCC without cirrhosis between January 1996 and March 2011 were retrieved retrospectively using a prospective database containing information on all patients who underwent hepatectomy for HCC. Patient and tumour characteristics were analysed for influence on overall and disease-free survival to identify prognostic factors by univariable and multivariable analysis.Results: The 1-, 3-and 5-year overall survival rates after resection with curative intent for HCC without cirrhosis were 84, 66 and 50 per cent respectively. Disease-free survival rates were 69, 53 and 42 per cent respectively. The 90-day mortality rate was 4·5 per cent (5 of 110 patients). Surgical radicality and growth pattern of the tumour were independent prognostic factors for overall survival. Disease-free survival after resection with curative intent was independently affected by growth pattern and by the number and size of tumour nodules. Conclusion:Liver resection for HCC without cirrhosis carries a low perioperative risk and excellent long-term outcome if radical resection is achieved.

Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma

“…A number of independent risk factors for decreased OS and RFS were found in the present study. These factors, such as portal hypertension, preoperative AFP level above 400 μg/l, tumour size above 5 cm, multiple tumour number, macroscopic vascular invasion, microscopic vascular invasion, satellites, blood transfusion and poor tumour differentiation, have been reported previously.…”

“…Significant differences were observed in baseline characteristics and clinical variables between the normal‐weight and underweight groups, including the presence of portal hypertension, macroscopic vascular invasion, poor differentiation, maximum tumour size above 5 cm, preoperative AFP level greater than 400 μg/l and the proportion of patients with Child–Pugh grade B disease. These features are known predictors of poor survival outcomes in HCC after curative liver resection.…”

Surgical treatment results of hepatocellular carcinoma in non‐cirrhotic liver in southern Chile: case series with follow‐up

“…Consequently, in light of reduced number of serious complications, mean post‐operative hospital stay of almost 7 days was observed. These figures are lower than those reported by other series, with POM data from 36% to 55% and mortality from 3.7% to 6.5% …”

Prognostic impact of soluble intercellular adhesion molecule‑1 in hepatocellular carcinoma

“…Newly-developed therapeutics using direct-acting antivirals are eradicating most HCVs (3). However, the prognosis of HCC remains poor owing to tumor invasiveness, intra-and extra-hepatic metastasis, multicentric carcinogenesis, and resistance to chemotherapy (4,5). The identification of novel biomarkers for HCC is therefore of great importance in improving the outcome of patients with HCC.…”