Prognostic factors affecting survival and recurrence after hepatic resection for hepatocellular carcinoma in cirrhotic liver

Wahab, Mohamed Abdel; El-Husseiny, Tarek Salah; Hanafy, Ehab El; Shobary, Mohamed El; Hamdy, Emad

doi:10.1007/s00423-010-0643-0

Cited by 57 publications

(33 citation statements)

References 36 publications

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“…Only one study reported the cancer-related survival data, it was impossible for us to adopt it to perform survival analysis. In total, 22 studies[8]; [9]; [17]; [18]; [19]; [20]; [21]; [22]; [23]; [24]; [25]; [26]; [27]; [28]; [29]; [30]; [31]; [32]; [33]; [34]; [35]; [36] met our inclusion criteria and were included in the final meta-analysis. Study characteristics were listed in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Of them, 4 studies[8]; [22]; [29]; [36] provided postoperative 3-year survival data and 12 studies[8]; [9]; [17]; [20]; [22]; [26]; [29]; [30]; [31]; [32]; [33]; [34]; [35]; [36] provided 5-year survival data. As shown in Figure 2A, meta-analysis data showed a significant higher death risk for patients with ABT than those without ABT during the 3 years after surgery, corresponding to a pooled of OR of 1.92 (95% CI:1.61–2.29, P<0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Postoperative 1-year data were available for five studies[9]; [17]; [19]; [21]; [30], 3-year data were reported by eleven studies[8]; [9]; [17]; [19]; [21]; [22]; [23]; [24]; [30]; [33]; [36] and 5-year data were provided by sixteen studies[8]; [9]; [17]; [19]; [20]; [21]; [22]; [23]; [24]; [26]; [27]; [28]; [29]; [30]; [31]; [32]; [33]; [34]; [35]; [36]. As displayed in Figure 3A, the result of meta-analysis suggested a significantly increased risk of recurrence for patients with ABT during the one year after surgery (OR = 1.70, 95% CI 1.38–2.10, P<0.001).…”

Section: Resultsmentioning

confidence: 99%

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Perioperative Allogenenic Blood Transfusion Is Associated with Worse Clinical Outcomes for Hepatocellular Carcinoma: A Meta-Analysis

et al. 2013

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Background and ObjectiveThe impact of perioperative allogenenic blood transfusion (ABT) on clinical outcomes for hepatocellular carcinoma (HCC) is conflicting and unclear. The aim of this meta-analysis is to evaluate the association between ABT and HCC clinical outcomes. Outcomes evaluated were all-cause death, tumor recurrence and postoperative complications.MethodsRelevant articles were identified through MEDLINE search (up to November 2012). Meta-analyses were performed by using the fixed or random effect models. Study heterogeneity was assessed by Q-test and I2 test. Publication bias was evaluated by funnel plots, Egger′s and Begg’s test.ResultsA total of 5635 cases from 22 studies finally met our inclusion criteria. Meta-analysis indicated HCC patients with ABT had an increased risk of all-cause death at 3 and 5 years after surgery (respectively: OR = 1.92, 95% CI, 1.61–2.29,P<0.001; OR = 1.60, 95% CI, 1.47–1.73,P<0.001 ) compared with those without ABT. The risk of tumor recurrence was significantly higher for ABT cases at 1, 3 and 5 years (respectively: OR = 1.70, 95% CI, 1.38–2.10, P<0.001; OR = 1.22, 95% CI, 1.08–1.38, P<0.001; OR = 1.16, 95% CI, 1.08–1.24, P<0.001). The HCC cases with ABT significantly increased postoperative complications occurrence compared with non-ABT cases (OR = 1.78,95% CI, 1.34–2.37, P<0.001).ConclusionsThe findings from the current meta-analysis demonstrated that ABT was associated with adverse clinical outcomes for HCC patients undergoing surgery, including increased death, recurrence and complications. Therefore, ABT should not be performed if possible.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Perioperative Allogenenic Blood Transfusion Is Associated with Worse Clinical Outcomes for Hepatocellular Carcinoma: A Meta-Analysis

et al. 2013

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“…[9,13,14] Conversely, for HCC, patients with wider negative margins were demonstrated to have improved long-term outcomes. [15,16] However, controversy still exists regarding the appropriate length of surgical margins in ICC resection. Previous literature [17] argued that the length of a clear resection margin had no impact on long-term survival, whereas other reports [18,19] documented long-term survival benefits in patients with clear margins of 10 mm or more in length compared with those with margins of less than 10 mm.…”

Section: Introductionmentioning

confidence: 99%

Influence of surgical margins on overall survival after resection of intrahepatic cholangiocarcinoma

Tang

Lü

Li³

et al. 2016

Medicine

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Background:Surgical resection is shown to present the best chance of cure in the treatment of intrahepatic cholangiocarcinoma (ICC). However, the appropriate length of the negative margin remains unclear. The aim of the present meta-analysis was to investigate whether a clear margin of 10 mm or more (≥10 mm) conferred any survival benefit over a margin of less than 10 mm (<10 mm) in patients with resected ICC.Methods:The meta-analysis was conducted in adherence with the PRISMA guidelines. PubMed, Web of Science, EMBASE, and the Cochrane Library were systematically searched to identify eligible studies published in English from the initiation of the databases to February 2016. Overall survival rates were pooled by using the hazard ratio and the corresponding 95% confidence interval (CI). Random-effect models were utilized because of between-study heterogeneity.Results:Six studies (eight cohorts) reporting on 712 patients were analyzed: 269 (37.80%) were in the 10 mm or more negative margin group, and 443 (62.20%) were in the less than 10 mm negative margin group. The pooled hazard ratio for the less than 10 mm group was found to be 1.59 (95% CI: 1.09–2.32) when this group was compared with the 10 mm or more group (reference), with moderate between-study heterogeneity (I2 = 45.30%, P = 0.07). Commensurate results were identified by sensitivity analysis.Conclusion:The result of this meta-analysis suggests a long-term survival (overall survival) advantage for negative margins of 10 mm or more in comparison with negative margins less than 10 mm for patients undergoing surgical resection of ICC.

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“…Hence, many investigations have studied risk factors for HCC recurrence after curative resection. Clinicopathologic characteristics of HCC such as micrometastasis, vascular invasion, and positive resection margin are well-known risk factors for tumor recurrence 5. Recently, peritumoral non-neoplastic liver parenchyma (PNLP) has been suggested to be an important predictive marker of HCC recurrence after surgical resection 6-8…”

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confidence: 99%

The Histologic Cut-off Point for Adjacent and Remote Non-neoplastic Liver Parenchyma of Hepatocellular Carcinoma in Chronic Hepatitis B Patients

et al. 2012

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BackgroundThe molecular profile of peritumoral non-neoplastic liver parenchyma (PNLP) has recently been suggested as predictive factor of early and late recurrence of hepatocellular carcinoma (HCC). However, there is no definite cut-off point for tumor-free PNLP in terms of either histological or molecular changes. Therefore, our aim is to determine the numerical cut-off point for separating adjacent PNLP and remote PNLP in histopathologic perspective.MethodsPeritumoral tissues from 20 resected HCC patients were sampled from 0 to 40 mm distance from the tumor border (divided into 5-mm columns). Histopathologic parameters such as necroinflammatory activity, fibrosis, bile ductular reaction, hepatic venulitis, peliosis, and steatosis were compared between each column.ResultsThe morphologic changes just adjacent to the tumor were notably severe and faded with distance. The parenchyma within 10 mm of the tumor showed significantly severe inflammation, fibrosis, peliosis and hepatic venulitis compared with those from farther areas. The histopathologic changes of the parenchyma became stable beyond 20 mm.ConclusionsResults of this study revealed that the parenchyma within 10 mm distance from the tumor, or adjacent PNLP, has histopathologic changes that are directly affected by the tumor, and the parenchyma beyond 20 mm as the remote PNLP without tumor effect.

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Prognostic factors affecting survival and recurrence after hepatic resection for hepatocellular carcinoma in cirrhotic liver

Abstract: In our experience, the prognostic factors after resection for recurrence and survival are different and multifactorial. However, resection of HCC in cirrhotic liver with preserved liver function is the treatment of choice in the present time and can be done with favorable results.

Cited by 57 publications

References 36 publications

Perioperative Allogenenic Blood Transfusion Is Associated with Worse Clinical Outcomes for Hepatocellular Carcinoma: A Meta-Analysis

Perioperative Allogenenic Blood Transfusion Is Associated with Worse Clinical Outcomes for Hepatocellular Carcinoma: A Meta-Analysis

Influence of surgical margins on overall survival after resection of intrahepatic cholangiocarcinoma

The Histologic Cut-off Point for Adjacent and Remote Non-neoplastic Liver Parenchyma of Hepatocellular Carcinoma in Chronic Hepatitis B Patients

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