Hepatic surgeons are like the child who rescued dying fishes

Yang, Tian; Lau, Wan Yee; Zhang, Han; Wu, Mengchao; Shen, Feng

doi:10.1002/hep.27980

Cited by 7 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 87 The potential benefit of increasing the number of patients undergoing LR needs to be weighed against the expected morbidity, mortality, and organ availability, should the patient be a candidate for salvage LT (SLT). 88 , 89 …”

Section: Evaluation Of Patients For Lr: Special Considerationsmentioning

confidence: 99%

Surgical Treatment of Hepatocellular Carcinoma

2017

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is a major cause of cancer-related death worldwide. In select patients, surgical treatment in the form of either resection or transplantation offers a curative option. The aims of this review are to (1) review the current American Association for the Study of Liver Diseases/European Association for the Study of the Liver guidelines on the surgical management of HCC and (2) review the proposed changes to these guidelines and analyze the strength of evidence underlying these proposals. Three authors identified the most relevant publications in the literature on liver resection and transplantation for HCC and analyzed the strength of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification. In the United States, the liver allocation system provides priority for liver transplantation to patients with HCC within the Milan criteria. Current evidence suggests that liver transplantation may also be indicated in certain patient groups beyond Milan criteria, such as pediatric patients with large tumor burden or adult patients who are successfully downstaged. Patients with no underlying liver disease may also benefit from liver transplantation if the HCC is unresectable. In patients with no or minimal (compensated) liver disease and solitary HCC ≥2 cm, liver resection is warranted. If liver transplantation is not available or contraindicated, liver resection can be offered to patients with multinodular HCC, provided that the underlying liver disease is not decompensated. Many patients may benefit from surgical strategies adapted to local resources and policies (hepatitis B prevalence, organ availability, etc). Although current low-quality evidence shows better overall survival with aggressive surgical strategies, this approach is limited to select patients. Larger and well-designed prospective studies are needed to better define the benefits and limits of such approach.

show abstract

Section: Evaluation Of Patients For Lr: Special Considerationsmentioning

confidence: 99%

Surgical Treatment of Hepatocellular Carcinoma

2017

View full text Add to dashboard Cite

show abstract

“…This approach of stratifying patients by tumor size goes against a substantial body of evidence from studies in Western and Asian countries that hepatic resection can be safe and effective in patients with single and multinodular HCC, regardless of tumor size, so long as resection is feasible based on tumor location and preserved liver function [10] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] . This highlights the need to expand official indications for hepatic resection [20] , [21] , [22] .…”

Section: Intermediate Hccmentioning

confidence: 99%

“…This reflects remarkable advances in radiological technology [13] , [14] , surgical techniques, and perioperative care. However, some liver care centers and official guidelines in the West do not recommend hepatic resection for such patients [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] .…”

Section: Introductionmentioning

confidence: 99%

Controversies and evidence of hepatic resection for hepatocellular carcinoma

et al. 2016

Self Cite

View full text Add to dashboard Cite

Symptoms of early hepatocellular carcinoma (HCC) often go unnoticed, so more than half of patients with primary HCC are diagnosed after their disease has already reached an intermediate or advanced stage, or after portal hypertension has appeared. While hepatic resection is widely recognized as a first-line therapy to treat very early or early HCC, its use in treating intermediate or advanced HCC or HCC involving portal hypertension remains controversial. Here we review PubMed-indexed literature covering the use of hepatic resection for such patients. The available evidence strongly suggests that, as a result of improvements in surgical techniques and perioperative care, hepatic resection can benefit many patients with intermediate or advanced HCC or with HCC associated with portal hypertension.

show abstract

Ignore reality but not the consequences of its ignorance: Broaden guidelines in surgery of hepatocellular carcinoma

Moris

Felekouras

2017

Hepatology

View full text Add to dashboard Cite

Hepatic surgeons are like the child who rescued dying fishes

Cited by 7 publications

References 4 publications

Surgical Treatment of Hepatocellular Carcinoma

Surgical Treatment of Hepatocellular Carcinoma

Controversies and evidence of hepatic resection for hepatocellular carcinoma

Ignore reality but not the consequences of its ignorance: Broaden guidelines in surgery of hepatocellular carcinoma

Contact Info

Product

Resources

About