Complications after Hepatectomy for Hepatocellular Carcinoma Independently Shorten Survival: A Western, Single-Center Audit

Doussot, Alexandre; Lim, Chetana; Lahat, Eylon; Salloum, Chady; Osseis, Michael; Gavara, Concepcion Gomez; Levesque, Éric; Féray, Cyrille; Compagnon, Philippe; Azoulay, Daniel

doi:10.1245/s10434-016-5746-6

Cited by 30 publications

(22 citation statements)

References 52 publications

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“…However, any under‐reporting of complication data would have been non‐systematic in nature. In addition, overall morbidity was consistent with data reported from other tertiary centers …”

Section: Discussionsupporting

confidence: 90%

“…In addition, overall morbidity was consistent with data reported from other tertiary centers. 18,19,22,46 In conclusion, postoperative morbidity following surgery for early stage HCC was relatively common as almost one in two patients experienced some type of complication. The occurrence of a postoperative complication was associated with worse long-term overall survival even after controlling for other competing risk factors on multivariable analysis.…”

Section: Discussionmentioning

confidence: 94%

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Prognostic impact of complications after resection of early stage hepatocellular carcinoma

Margonis

Sasaki

Andreatos

et al. 2017

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Prognostic impact of complications after resection of early stage hepatocellular carcinoma

Margonis

Sasaki

Andreatos

et al. 2017

Journal of Surgical Oncology

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“…Satellite nodules are an independent risk factor for tumor recurrence and patient survival 37 . The presence of satellite nodules was independently associated with the occurrence of postoperative complications 38 . In this study, tumor diameter and satellite nodules reflected the invasiveness of HCC, and they were significantly associated with EHMs.…”

Section: Discussionmentioning

confidence: 94%

A Nomogram Predicting Extrahepatic Metastases for Patients with Adjuvant Transarterial Chemoembolization after Hepatectomy

Chen¹,

Gao²,

Zheng³

et al. 2018

J. Cancer

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Background: Prognosis remains poor for hepatocellular carcinoma (HCC) patients with extrahepatic metastases (EHMs). This study aimed to develop a nomogram to predict EHMs in HCC patients who underwent adjuvant transarterial chemoembolization (TACE) following hepatectomy.Methods: Data of 578 HCC patients who underwent TACE after hepatectomy at the Eastern Hepatobiliary Surgery Hospital was retrospectively reviewed. Cox regression analyses was used to select variables to construct the nomogram. Predictive accuracy and discriminative ability of the model were performed using concordance index (C-index), calibration curve and the area under time-dependent receiver operating characteristic (ROC) curve.Results: Postoperative EHMs were detected in 89 and 31 patients in the training cohort (n = 453) and validation cohort (n = 125), respectively. Multivariate analysis showed that tumor size (HR, 1.099; 95% CI, 1.049-1.152), coarse beam type of tumor histopathological structure (HR, 2.382; 95% CI, 1.030-5.512), presence of satellite nodules (HR, 1.936; 95% CI, 1.156-3.244) and alpha-fetoprotein (AFP) (HR, 1.399; 95% CI, 1.098-1.783) were independent risk factors for EHMs (all p < 0.05). The nomogram incorporated these factors achieved good agreement between prediction and actual observation with a concordance index (C-index) of 0.73 (95% CI, 0.68 to 0.78) and 0.71 (95% CI, 0.63 to 0.79) in the training cohort and validation cohort, respectively. In addition, patients who had a nomogram score > 17 were considered to have higher risk for EHMs compared with those scored ≤ 12. Furthermore, the time-dependent area under the ROC curve indicated comparative stability and adequate discriminative ability of the model.Conclusions: This novel nomogram can identify those with high risk of EHMs after adjuvant TACE following hepatectomy. The validation cohort showed a good performance, suggesting it could benefit surgeons on decision-making.

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“…Margir rannsakendur telja þetta því ekki til fylgikvilla, sem getur skýrt mun á fylgikvillum í flokki Clavien-Dindo 1-2. 30 Margir þaettir geta haft áhrif á endurkomu, til daemis aexlisvöxtur í skurðbrún, innvöxtur krabbameins í aeðar og aexlishreiður umhverfis meginaexli. Mikilvaegt er að leitast við að gera aðgerðir á heilum lifrargeirum til að möguleg aexlishreiður fylgi með þar sem vöxtur lifrarfrumukrabbameins verður eftir aeðastilkum innan lifrar.…”

Section: Umraeðaunclassified

Skurðmeðferð lifrarfrumukrabbameins á Landspítala 1993-2012

Höskuldsdóttir

Blöndal

Jónasson

et al. 2017

LBL

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Complications after Hepatectomy for Hepatocellular Carcinoma Independently Shorten Survival: A Western, Single-Center Audit

Abstract: POCs should be considered as a long-term prognostic factor. Careful patient selection requiring underlying liver assessment and appropriate strategy, such as mini-invasive surgery and restricted transfusion policy, might be promoted to prevent POCs.

Cited by 30 publications

References 52 publications

Prognostic impact of complications after resection of early stage hepatocellular carcinoma

Prognostic impact of complications after resection of early stage hepatocellular carcinoma

A Nomogram Predicting Extrahepatic Metastases for Patients with Adjuvant Transarterial Chemoembolization after Hepatectomy

Skurðmeðferð lifrarfrumukrabbameins á Landspítala 1993-2012

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