Partial Hepatectomy With Wide Versus Narrow Resection Margin for Solitary Hepatocellular Carcinoma

Shi, Ming; Guo, Rong; Lin, Xiao Jun; Zhang, Ya Qi; Chen, Min Shan; Zhang, Chang Qing; Lau, Wan Yee; Li, Jin Qing

doi:10.1097/01.sla.0000231758.07868.71

Cited by 440 publications

(336 citation statements)

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“…In comparison to other studies evaluating the recurrence in HBV related HCCs; the role of the resection margin is also controversial. Some studies supported a wide safety margin (more than 1 cm) and found it a significant predictor of tumour recurrence [13,14]. Other studies found no significant association between safety margin and tumour recurrence [15][16][17].…”

Section: Discussionmentioning

confidence: 82%

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

Wahab

Shehta

Hamed

et al. 2014

EAJM

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Objective: Egypt is one of the hot spots in the international map of Hepatocellular carcinoma (HCC), which is where hepatitis C virus (HCV) infection is the major risk factor in development of HCC (80%). Due to low organ donation rates and lack of deceased liver transplantation, hepatic resection is the main line of treatment for HCC patients with sufficient liver reserve. We introduce our experience with patients who had HCV related HCC who underwent hepatic resection to determine various predictors of tumour recurrence in this group. This is the first study to come from a country where chronic HCV hepatitis is endemic. Materials and Methods:This is a retrospective cohort study of 208 cases of HCC in hepatitis C virus positive patients with cirrhotic livers who underwent first-time liver resection, in Gastroenterology Surgical Centre, Mansoura University, Egypt during the period from January 2002 to December 2011. Shapiro-Wilk test was used to assess normality of data. Predictors of HCC recurrence were assessed by bivariate correlation tests, univariate analysis using the chi-square and t-test and binary logistic regression analysis. A P value <0.05 was considered statistically significant.Results: Tumour recurrence occurred in 88 patients (42.3%). Most of the recurrences occurred within the first year 55 patients (62.5%). The most common site for recurrence was the liver (n=68, 77.3%). Based on the univariate analysis; significant variables predicting tumor recurrence were alpha feto-protein (AFP), blood transfusion, multifocality, cut margin, microvascular invasion, lack of capsule, tumour grade and stage. Based on multivariate analysis, the main variables predicting tumor recurrence were blood transfusion, cut margin, tumour capsule and microvascular invasion. Conclusion:Although the predictors of recurrence are the same for both HBV and HCV related HCC, the rate and aggressiveness of recurrence are higher in HCV related HCC.Key Words: HCV related HCCs, liver resection, recurrent HCC Özet Amaç: Mısır; hepatit C virüsü (HCV) enfeksiyonunun Hepatocellular karsinomun (HCC) görülmesinde önemli (% 80) bir risk faktörü olduğu, uluslararası HCC haritasındaki sıcak noktalardan biridir. Organ bağışı oranlarının düşük olması ve kadavradan karaciğer nakli eksikliği sebebiyle, karaciğer rezeksiyonu, yeterli karaciğer rezervi olan HCC hastalarının tedavisinde ana yöntemdir. Bu grupta HCV'ye bağlı HCC'si olan hastalarda tümör nüksünün çeşitli faktörlerini araştırmak için karaciğer rezeksiyonu deneyimimizi aktarmak amacındayız. Bu, kronik HCV hepatitinin endemik olduğu bir ülkeden gelen ilk çalış-madır. Gereç ve Yöntem:Bu, Ocak 2002-Aralık 2011 süresince Mısır'ın Mansoura Üniversitesi, Gastroenterolojik Cerrahi Merkezinde ilk kez karaciğer rezeksiyonu yapılan sirotik karaciğerli HCC, hepatit C virüsü pozitif hastalarda 208 vakanın retrospektif kohort çalışmasıdır. Verilerin normalliğini değerlendirmek için Shapiro-Wilk testi kullanılmıştır. HCC nüks prediktörleri ikili korelasyon testleri, tek değişkenli ki-kare ve...

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Section: Discussionmentioning

confidence: 82%

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

Wahab

Shehta

Hamed

et al. 2014

EAJM

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“…Among patients who presented recurrence, 4 had liver cirrhosis (HCV-related in 2 cases, steatohepatitic in one case and alcohol-related in the remaining one), 2 were affected by nonalcoholic steatohepatitis, and 1 had healthy liver. In the eight patients who did not display recurrence, the median follow-up was 21 months (range [16][17][18][19][20][21][22][23][24][25][26]. The only significant difference found between subjects with and without recurrence was age displayed recurrence, compared to those who remained cancer-free during follow-up (p=0.02) ( Table 4 and Fig.…”

Section: Resultsmentioning

confidence: 99%

HepPar1-Positive Circulating Microparticles are Increased in Subjects with Hepatocellular Carcinoma and Predict Early Recurrence after Liver Resection

Abbate

Marcantoni

Giuliante

et al. 2017

Preprint

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Circulating microparticles (MPs) are novel potential biomarkers in cancer patients. Their role in hepatocellular carcinoma (HCC) is under intensive investigation. In this study we tested the hypothesis that MPs expressing the antigen HepPar1 are increased in the blood of subjects with HCC and may serve as markers of early recurrence after liver resection (LR). We studied fifteen patients affected by HCC undergoing LR and used flow cytometry to assess the number of circulating HepPar1+ MPs. Ten subjects without HCC (five with liver cirrhosis and 5 with healthy liver) were used as controls. After LR, HCC patients were followed-up for early recurrence, which occurred in seven cases. The number of circulating HepPar1+ MPs was significantly higher in subjects affected by HCC, compared to individuals without cancer (p<0.01). We also found that, among HCC patients, the number of circulating HepPar1+ MPs, measured before LR, was significantly higher in those who displayed early recurrence compared to those without recurrence (p=0.02). Of note, other types of circulating MPs, such as those derived from endothelial cells (CD144+) or those produced by the activated endothelium (CD144+/CD62+) were not associated with HCC, neither could predict HCC recurrence. HepPar1+ MPs deserve further investigation as novel biomarkers of disease and prognosis in HCC patients.

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“…Portal hypertension, hepatic venous pressure gradient (HVPG) ≥ 10 mmHg, was found to be the best predictor of postoperative liver decompensation and poor long-term outcomes in compensated cirrhotic patients undergoing hepatic resection [10]. Postresection tumor recurrences often have multifocal presentations and repeat resections are rarely ideal, instead, salvage liver transplantation, or other loco-regional therapies, with or without oral multi-kinase inhibitors are more suitable.…”

Section: Resectionmentioning

confidence: 99%

Introductory Chapter: Updates on the Management of Hepatocellular Carcinoma

Gomaa¹,

Alkhatib²,

Alkilany³

et al. 2017

Updates in Liver Cancer

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Partial Hepatectomy With Wide Versus Narrow Resection Margin for Solitary Hepatocellular Carcinoma

Abstract: For macroscopically solitary HCC, a resection margin aiming grossly at 2 cm efficaciously and safely decreased postoperative recurrence rate and improved survival outcomes when compared with a gross resection margin aiming at 1 cm, especially for HCC < or =2 cm.

Cited by 440 publications

References 31 publications

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

HepPar1-Positive Circulating Microparticles are Increased in Subjects with Hepatocellular Carcinoma and Predict Early Recurrence after Liver Resection

Introductory Chapter: Updates on the Management of Hepatocellular Carcinoma

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