Improving Survival Results After Resection of Hepatocellular Carcinoma: A Prospective Study of 377 Patients Over 10 Years

Poon, Ronnie Tung‐Ping; Fan, Sheung‐Tat; Lo, Chung‐Mau; Ng, Irene Oi–Lin; Liu, Chi‐Leung; Lam, Chi‐Ming; Wong, John

doi:10.1097/00000658-200107000-00010

Cited by 535 publications

(355 citation statements)

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“…However, most of these studies included patients with metastatic liver cancer or benign liver tumours who had normal parenchyma in the non-cancerous region of the liver. Transfusion rates and mean blood loss during hepatectomy for patients suffering from HCC, most of whom in East Asian countries have underlying liver disease, are still over 30 per cent and over 1000 ml respectively 2,15,25 .…”

Section: Discussionmentioning

confidence: 99%

Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease

Itamoto

Katayama

Nakahara

et al. 2003

British Journal of Surgery

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Background: Preoperative autologous blood donation has been suggested for patients with liver disease who are to undergo liver resection. The aim of this retrospective study was to clarify the risk factors for increased blood loss and the need for blood transfusion during hepatectomy for hepatocellular carcinoma (HCC).Methods: From January 1996 to December 2000, 206 consecutive patients, 98·5 per cent of whom had underlying liver disease, underwent elective hepatectomy for HCC.Results: Major hepatectomy was performed in 34 patients (16·5 per cent) and minor hepatectomy in 172 patients (83·5 per cent). The mean blood loss was 410 (median 260) ml. Eleven (5·3 per cent) of the 206 patients received blood transfusion during or after the operation. Operation time (P = 0·004) and central venous pressure (CVP) (P = 0·041) were independently correlated with blood loss of more than 1000 ml. Only preoperative haemoglobin level (P = 0·001) was independently correlated with the need for blood transfusion. Conclusion:In patients with underlying liver disease, maintaining CVP at a level below 5 cmH 2 O during parenchymal transection to reduce blood loss is more important than reserving autologous blood before the operation.

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Section: Discussionmentioning

confidence: 99%

Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease

Itamoto

Katayama

Nakahara

et al. 2003

British Journal of Surgery

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“…However, thus far, no randomized trial comparing open and laparoscopic liver resection has been reported. The 5-year survival after resection of HCC is 35-50% in recent large cohort studies [257][258][259]. The long-term survival after hepatic resection depends on tumor characteristics.…”

Section: Liver Resectionmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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“…In Taiwan, HCC is a leading neoplasm due to the high prevalence of chronic viral hepatitis [3][4][5] . Surgical resection, liver transplantation and local ablation therapy are considered potentially curative therapies for HCC nowadays [6,7] . However, only 9% to 27% of patients are suitable for operation [8,9] .…”

Section: Introductionmentioning

confidence: 99%

Factors for early tumor recurrence of single small hepatocellular carcinoma after percutaneous radiofrequency ablation therapy

Cheng²,

Lai³

et al. 2005

WJG

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AIM:To evaluate the factors affecting the early tumor recurrence within one year in cirrhotic patients having a single small hepatocellular carcinoma (HCC) after complete tumor necrosis by radiofrequency ablation (RFA) therapy. METHODS:Thirty patients with a single small HCC received RFA therapy by a RFA 2000 generator with LeVeen needle. Tri-phase computerized tomogram was followed every 2 to 3 mo after RFA. The clinical effects and tumor recurrence were recorded. RESULTS:The initial complete tumor necrosis rate was 86.7%. Twenty-two patients were followed for more than one year. The local and overall recurrence rates were 13.6% and 36.4%, 33.3% and 56.2%, 46.6% and 56.2% at 12, 24 and 30 mo, respectively. No major complication or procedure-related mortality was found. The risk factors for early local tumor recurrence within one year were larger tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging. The age of patients with new tumor formation within one year was relatively younger (55.1±8.3 vs 66.7±10.8, P = 0.029). CONCLUSION:Large tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging are the risk factors for early local tumor recurrence within one year, and young age is the positive predictor for new tumor formation within one year.

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Improving Survival Results After Resection of Hepatocellular Carcinoma: A Prospective Study of 377 Patients Over 10 Years

Abstract: ObjectiveTo investigate whether the survival results after resection of hepatocellular carcinoma (HCC) have improved within the past decade by an analysis of a prospective cohort of patients over a 10-year period.

Cited by 535 publications

References 43 publications

Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease

Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Factors for early tumor recurrence of single small hepatocellular carcinoma after percutaneous radiofrequency ablation therapy

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