Prognostic factors and survival after hepatic resection for hepatocellular carcinoma without cirrhosis

Nagasue, Naofumi; Ono, Takashi; Yamanoi, Akira; Kohno, Hitoshi; El-Assal, Osama N.; Taniura, Hiroyuki; Uchida, Masaaki

doi:10.1046/j.1365-2168.2001.01732.x

Cited by 136 publications

(105 citation statements)

References 25 publications

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“…A recent study showed, that hepatitis C virus infection is associated with increased risk of intrahepatic recurrence after HR of HCC in patients without cirrhosis. 21 However, in patients with cirrhosis, the etiology of liver disease appeared not to be related to survival after HR for HCC. [23][24][25][26][27][28] Several studies have compared the outcomes of LT and HR in HCC, but failed to show conclusive results 8,10,14,15,17,19 (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Small hepatocellular carcinoma in Child A cirrhotic patients: Hepatic resection versus transplantation

Bigourdan

2003

Liver Transplantation

158

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Hepatic resection (HR) is the treatment of choice for small hepatocellular carcinoma (HCC) in a noncirrhotic liver, whereas liver transplantation (LT) offers better results in patients with impaired hepatic function (Child B and C). However, it is still debated whether HR or LT is the best strategy for patients with Child A cirrhosis. We conducted a retrospective study on 37 consecutive patients with Child A cirrhosis and small HCC, treated between 1991 and 1999. Seventeen of these patients, who underwent LT, were compared with 20 patients who underwent HR, and prognostic factors for survival and tumor recurrence were analyzed. The primary endpoints were the intentionto-treat, 3-and 5-year survival, and 3-and 5-year recurrence-free survival. Three-and 5-year patient survival rate both were significantly (P ‫؍‬ .04) higher in the LT group (87% and 71%, respectively) than in the HR group (67 and 36% respectively). Similarly, the 3-and 5-year recurrence-free survival rates were 87% and 80% for the LT group, and 52% and 40% for the HR group (P ‫؍‬ .03). Absence of microscopic vascular invasion was the only other prognostic factor correlated with significantly better recurrence-free survival (P ‫؍‬ .02). Therefore, we concluded that in patients with Child A cirrhosis and small HCC, liver transplantation resulted in better overall and disease-free survival than HR. (Liver Transpl 2003;9: 513-520.)

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Section: Discussionmentioning

confidence: 99%

Small hepatocellular carcinoma in Child A cirrhotic patients: Hepatic resection versus transplantation

Bigourdan

2003

Liver Transplantation

158

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“…Liver Resection [7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] (Table 1) The articles reviewed for information on partial liver resection for NC-HCC include 2263 patients; the numbers of patients in these series range from 20 to 254. [7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The results of the French multicenter ...…”

Section: Resultsmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The results of the French multicenter study, 1 which includes the world's largest series of resections for HCC arising in normal livers (ie, nonfibrotic and noncirrhotic), are discussed separately. The larger studies come from regions with high rates of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.…”

Section: Resultsmentioning

confidence: 99%

Place of liver transplantation in the treatment of hepatocellular carcinoma in the normal liver

et al. 2011

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Hepatocellular carcinoma (HCC) is a relatively common cancer and occurs mainly in patients with liver cirrhosis (85%-95%). A significant number of cases are, however, diagnosed in normal and noncirrhotic/nonfibrotic livers. In contrast to HCC in a cirrhotic liver, noncirrhotic hepatocellular carcinoma (NC-HCC) predominantly occurs in young and healthy female patients in their 30s, and the diagnosis is frequently made at an advanced stage in the absence of a clear etiological factor. [1][2][3] The same holds true for the uncommon fibrolamellar hepatocellular carcinoma (FL-HCC) variant. [1][2][3] Several studies have shown that the 3-year overall survival (OS) rates with different pharmaceutical, radiological, and surgical therapies for HCC (if they are adequately performed) are approximately 60%. 4 After 3 years, the results of these treatments start to diverge substantially with respect to OS and, most importantly, with respect to disease-free survival (DFS). Long-term follow-up (5-10 years) has clearly shown that surgical resection is the only curative treatment for any kind of HCC. [2][3][4][5] With respect to very long-term DFS (>5 years), liver transplantation (LT) offers the best results. 2,4-6 In order to be successful, surgery has to be adapted to the tumor, the underlying condition of the patient, and the patient's liver. Liver resection and LT should have complementary roles rather than competing ones, and they should be associated with each other instead of being opposed. 5 Partial resection for HCC can be considered only for patients with well-compensated cirrhosis or fibrosis or with normal liver tissue. For patients with decompensated liver disease, cirrhosis, or a technically unresectable tumor, LT offers the best chance for a cure. This option indeed addresses the tumor as well as the underlying liver disease.Despite the extensive experience with LT for the treatment of HCC in patients with cirrhosis, the experience with LT for the treatment of NC-HCC is anecdotal and is limited to situations in which resection is not possible.The aims of this study were as follows: (1) to analyze the results from recent series of partial liver resections for NC-HCC, (2) to compare these results with the results of LT for the same condition; and (3) to propose an adaptation of the therapeutic algorithm for NC-HCC on the basis of these analyses.

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“…GGT was utilized as a diagnostic tumor biomarker for liver disease with a high sensitivity of 83-100%, but it only has a low specificity of 32% (10). Therefore, long since GGT was not utilized as an (29,(36)(37)(38)(39)(40). The combination of GGT and other indicators, such as tumor size, tumor number, MVI, or laboratory data for AFP and DCP, should be paid more attention when deciding a treatment and predicting the curative results for patients with HCC (41).…”

Section: Ggt As a Predictive Biomarker In Clinical Investigationsmentioning

confidence: 99%

Advances of diagnostic and mechanistic studies of γ-glutamyl transpeptidase in hepatocellular carcinoma

Xia

Song

Sun

et al. 2016

DD&T

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Prognostic factors and survival after hepatic resection for hepatocellular carcinoma without cirrhosis

Abstract: In the treatment of HCC without cirrhosis, major hepatectomy is advocated to prevent early recurrence. Liver transplantation may be required for patients with HCV infection.

Cited by 136 publications

References 25 publications

Small hepatocellular carcinoma in Child A cirrhotic patients: Hepatic resection versus transplantation

Small hepatocellular carcinoma in Child A cirrhotic patients: Hepatic resection versus transplantation

Place of liver transplantation in the treatment of hepatocellular carcinoma in the normal liver

Advances of diagnostic and mechanistic studies of γ-glutamyl transpeptidase in hepatocellular carcinoma

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