Preoperative strategies to increase liver volume are effective in achieving resectability of HCC. TACE + PVE is as safe as PVL/PVE providing higher OS. ALPPS is associated with a higher risk of PHLF, major complications, and mortality. RE despite the small experience seems to present similar resection rate and OS as TACE + PVE with higher rate of major complications.
Intrahepatic lymphatic invasion is a significant prognostic factor. Other mechanisms of invasion, although frequently observed, are not related to recurrence or survival, suggesting that the lymphatic system is the main route for dissemination of CRCLM. Furthermore, immunohistochemical detection of intrahepatic lymphatic invasion might be of value in clinical practice.
The liver is the most common site of distant metastases in patients with colorectal cancer. Surgery represents the mainstream for curative treatment of colorectal cancer liver metastases (CRCLM) with long-term survival up to 58 and 36 % at 5 and 10 years, respectively. Despite advances on diagnosis, staging and surgical strategies, 60-70 % of patients will develop recurrence of the disease even after R0 resection of CRCLM. Tumor staging, prognosis, and therapeutic approaches for cancer are most often based on the extent of involvement of regional lymph nodes (LNs) and, to a lesser extent, on the invasion of regional lymphatic vessels draining the primary tumor. For CRCLM, the presence of intra hepatic lymphatic and blood vascular dissemination has been associated with an increased risk of intra hepatic recurrence, poorer disease-free and overall survival after liver resection. Also, several studies have reviewed the role of surgery in the patient with concomitant CRCLM and liver pedicle LN metastasis. Although pedicle LN involvement is related to worst survival rates, it does not differentiate patients that will relapse from those that will not. This review aims to briefly describe the anatomy of the liver's lymphatic drainage, the incidence of intrahepatic lymphatic invasion and hilar lymph node involvement, as well as their clinical impact in CRCLM. A better understanding of the role of liver lymphatic metastasis might, in the near future, impact the strategy of systemic therapies after liver resection as for primary colorectal tumors.
Background: Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer
and its incidence is increasing around the world in the last decades, making it
the third cause of death by cancer in the world. Hepatic resection is one of the
most effective treatments for HCC with five-year survival rates from 50-70%,
especially for patients with a single nodule and preserved liver function. Some
studies have shown a worse prognosis for HCC patients whose etiology is viral.
That brings us to the question about the existence of a difference between the
various causes of HCC and its prognosis. Aim: To compare the prognosis (overall and disease-free survival at five years) of
patients undergoing hepatectomy for the treatment of HCC with respect to various
causes of liver disease. Method: Was performed a review of medical records of patients undergoing hepatectomy
between 2000 and 2014 for the treatment of HCC. They were divided into groups
according to the cause of liver disease, followed by overall and disease-free
survival analysis for comparison. Results:There was no statistically significant difference in the outcomes of the groups of
patients divided according to the etiology of HCC. Overall and disease-free
survival at five years of the patients in this sample were 49.9% and 40.7%,
respectively. Conclusion: From the data of this sample, was verified that there was no prognostic
differences among the groups of HCC patients of the various etiologies.
Liver resection is a good therapeutic option for patients with complex postoperative biliary stricture and vascular injury presenting with liver atrophy/abscess in which previous hepaticojejunostomy has failed.
Treatment in a multidisciplinary cancer center led to changes in oncological and surgical management. Perioperative chemotherapy was frequently employed, and surgeons adopted a conservative approach to liver parenchyma.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.