Risk factors linked to postoperative morbidity in patients with hepatocellular carcinoma

Shimada, Mitsuo; Takenaka, Katsuto; Fujiwara, Yuh; Gion, Tomonobu; Shirabe, Ken; Yanaga, Katsuhiko; Sugimachi, Keizō

doi:10.1046/j.1365-2168.1998.00567.x

Cited by 150 publications

(112 citation statements)

References 15 publications

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“…In addition to this finding, we also observed that the size of tumor and blood transfusion were predictors of major postoperative complications. Blood transfusion has long been associated with tumor recurrence (20,23) and also with morbidity and mortality (7,11,14,28) . KOOBY et al (15) revealed that perioperative blood transfusion is a risk factor for poor outcome after liver resection.…”

Section: Discussionmentioning

confidence: 99%

Liver resection: 10-year experience from a single Institution

Coelho

Claus

Machuca

et al. 2004

Arq. Gastroenterol.

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BACKGROUND: Liver resection constitutes the main treatment of most liver primary neoplasms and selected cases of metastatic tumors. However, this procedure is associated with significant morbidity and mortality rates. AIM: To analyze our experience with liver resections over a period of 10 years to determine the morbidity, mortality and risk factors of hepatectomy. PATIENTS AND METHODS: Retrospective review of medical records of patients who underwent liver resection from January 1994 to March 2003. RESULTS: Eighty-three (41 women and 42 men) patients underwent liver resection during the study period, with a mean age of 52.7 years (range 13-82 years). Metastatic colorectal carcinoma and hepatocellular carcinoma were the main indications for hepatic resection, with 36 and 19 patients, respectively. Extended and major resections were performed in 20.4% and 40.9% of the patients, respectively. Blood transfusion was needed in 38.5% of the operations. Overall morbidity was 44.5%. Life-threatening complications occurred in 22.8% of cases and the most common were pneumonia, hepatic failure, intraabdominal collection and intraabdominal bleeding. Among minor complications (30%), the most common were biliary leakage and pleural effusion. Size of the tumor and blood transfusion were associated with major complications (P = 0.0185 and P = 0.0141, respectively). Operative mortality was 8.4% and risk factors related to mortality were increased age and use of vascular exclusion (P = 0.0395 and P = 0.0404, respectively). Median hospital stay was 6.7 days. CONCLUSION: Liver resections can be performed with low mortality and acceptable morbidity rates. Blood transfusion may be reduced by employing meticulous technique and, whenever indicated, vascular exclusion.

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Section: Discussionmentioning

confidence: 99%

Liver resection: 10-year experience from a single Institution

Coelho

Claus

Machuca

et al. 2004

Arq. Gastroenterol.

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“…Third, the laparoscopic approach is associated with lower intraoperative blood loss due to the haemostatic effect of the positive pressure of peritoneum, meticulous intraoperative manipulations of the tissue under magnification, and smaller abdominal incisions. It was reported that intraoperative blood loss is a major risk factor of postoperative morbidity and death [18].…”

Section: Lrfa Advantagesmentioning

confidence: 99%

“…Imaging examinations include percutaneous abdominal ultrasound, computer tomography, magnetic resonance imaging (MRI), chest Rx, and, in selected cases, positron emission tomography using 18 FDG [12].…”

Section: Patient Preparation For Lrfamentioning

confidence: 99%

Laparoscopic Radiofrequency Ablation of Liver Tumors

Boeti¹,

Grigorie²,

Popescu³

2013

Hepatic Surgery

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“…Because of recent advances in surgery, HCC has shown improved prognosis. 1,2 However, the efficacy of this invasive treatment is limited because almost all patients with HCC also suffer from serious liver dysfunction due to hepatitis and cirrhosis. Several less invasive approaches, such as lipidolization, transarterial embolization, or percutaneous ethanol injection therapy, have been used also to treat HCC, but the therapeutic efficacies of these are also limited.…”

mentioning

confidence: 99%

“…Third, HCC may frequently recur in cirrhotic liver, and thus, repeated injections are necessary to treat HCC. 1,2 An adenovirus vector can achieve a high transduction rate of therapeutic genes, but the gene transfection efficiency by repeated administration of this vector is likely to be reduced by an antiadenovirus antibody. 8 We therefore chose liposomes of the hemagglutinating virus of Japan ( HVJ ) , a viral /nonviral hybrid vector, 9 as a gene transfer vector of HCC because this system has shown a relatively low immunogenicity 10 and repeated gene transfection to liver without reduction of gene transfer efficiency in vivo.…”

mentioning

confidence: 99%

Preclinical and therapeutic utility of HVJ liposomes as a gene transfer vector for hepatocellular carcinoma using herpes simplex virus thymidine kinase

et al. 2001

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Although gene therapy has been suggested to be a novel strategy to treat hepatocellular carcinoma ( HCC ) , no study showing the clinical feasibility of vectors to treat HCC has been reported. In this preclinical study, we show evidence indicating that hemagglutinating virus of Japan ( HVJ ) liposomes are a feasible vector to treat HCC in a clinical setting using ganciclovir ( GCV ) and herpes simplex virus thymidine kinase ( HSV -tk ) , which is driven by the cytomegalovirus immediate early enhancer / promoter ( plasmid pcDNA3 / HSV -tk ) . In in vitro experiments, almost complete tumor cell regression was achieved with the optimal GCV concentration ( 100 g / mL ) and more than 1 / 3 regression was seen even with a 20% transduction ratio using HuH7 HCC cells stably transformed by HSV -tk. HVJ liposomes showed a 19.7% ( mean ) transduction rate of the lacZ gene in a relatively large mass of more than 300 mm 3 in vivo, which is a clinically detectable size, implanted into SCID mice. Moreover, a single HSV -tk injection of HVJ liposomes followed by GCV treatment inhibited tumor growth at least within a week, and repeat administration was more effective. Furthermore, subcutaneous injection of an HVJ liposomes vehicle induced no apparent inflammatory response in C3H / HeN mice, whereas lacZ gene transfection resulted in inflammatory pathology, suggesting a lower immunogenicity of the HVJ envelope protein than those of bacteria -derived plasmid DNA or the -galactosidase gene product. From these findings, we conclude that HVJ liposomes are a clinically safe and effective gene transfer vector to treat HCC. Cancer Gene Therapy ( 2001 ) 8, 252 ± 258

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Risk factors linked to postoperative morbidity in patients with hepatocellular carcinoma

Cited by 150 publications

References 15 publications

Liver resection: 10-year experience from a single Institution

Liver resection: 10-year experience from a single Institution

Laparoscopic Radiofrequency Ablation of Liver Tumors

Preclinical and therapeutic utility of HVJ liposomes as a gene transfer vector for hepatocellular carcinoma using herpes simplex virus thymidine kinase

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