IS RESECTION OF HEPATOCELLULAR CARCINOMA IN THE ERA OF LIVER TRANSPLANTATION WORTHWILE? A single center experience

Herman, Paulo; Lopes, Felipe de Lucena Moreira; Krüger, Jaime Arthur Pirola; Fonseca, Gilton Marques; Jeismann, Vagner Birk; Coelho, Fabrício Ferreira

doi:10.1590/s0004-28032016000300009

Cited by 10 publications

(23 citation statements)

References 47 publications

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“…Laparoscopic approach for liver resection is gaining space worldwide, especially in the treatment of benign tumors as hepatocellular adenoma 8 , 17 , which is more common in young women, and in the treatment of hepatocellular carcinoma 8 , 18 , with a likely advantage over conventional open approach. According to Kawaguchi et al 21 , the relative number of 30% of minimally invasive approach for all liver resections is the average for specialized centers.…”

Section: Discussionmentioning

confidence: 99%

Liver Resection in Brazil: A National Survey

Fonseca

Jeismann

Krüger

et al. 2018

ABCD, arq. bras. cir. dig.

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Background:Liver surgery has developed significantly in the past decades. In Brazil, the interest on it has grown significantly, but there is no study regarding its clinical practice. Despite intrinsic limitations, surveys are well suited to descriptive studies and allow understanding the current scenario. Aim:To provide an overview on the current spread of liver surgery in Brazil, focusing on groups´ profile, operative techniques and availability of resources. Method:From May to November 2016, was conducted a national survey about liver surgery profile in Brazil composed by 28 questions concerning surgical team characteristics, technical preferences, surgical volume, results and available institutional resources. The survey was sent by e-mail to 84 liver surgery team leaders from different centers including all regions of the country. Results:Forty-three study participants (51.2%), from all Brazilian regions, responded the survey. Most centers have residency/fellowship programs (86%), perform and do laparoscopic procedures (91%); however, laparoscopy is still responsible for a little amount of surgeries (1-9% of laparoscopic procedures over all liver resections in 39.5% of groups). Only seven centers (16.3%) perform more than 50 liver resections/year. Postoperative mortality rate is between 1-3% in 55% of the centers. Conclusion:This is the first depiction of liver surgery in Brazil. It showed a surgical practice aligned with worldwide excellence centers, concentrated on hospitals dedicated to academic practice.

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Section: Discussionmentioning

confidence: 99%

Liver Resection in Brazil: A National Survey

Fonseca

Jeismann

Krüger

et al. 2018

ABCD, arq. bras. cir. dig.

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“…Hepatocellular carcinoma is a malignancy associated with a high rate of mortality and costs (4) . Hepatocellular carcinoma (HCC) currently, affects 1.5% of the world population and reach approximately 15% of patients on the waiting list for liver transplantation (1,11,21) . Mishra et al (28) has demonstrated that the costs of treating patients with HCC in 2009 were around US$ 31 thousand, with total treatment costs of ap proximately US$ 2 billion in the USA.…”

Section: Introductionmentioning

confidence: 99%

Higher MELD score increases the overall cost on the waiting list for liver transplantation: a micro-costing analysis based study

Turri

Decimoni

Ferreira

et al. 2017

Arq. Gastroenterol.

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-Background -The pretransplant period is complex and includes lots of procedures. The severity of liver disease predisposes to a high number of hospitalizations and high costs procedures. Economic evaluation studies are important tools to handle costs on the waiting list for liver transplantation. Objective -The objective of the present study was to evaluate the total cost of the patient on the waiting list for liver transplantation and the main resources related to higher costs. Methods -A cost study in a cohort of 482 patients registered on waiting list for liver transplantation was carried out. In 24 months followup, we evaluated all costs of materials, medicines, consultations, procedures, hospital admissions, laboratorial tests and image exams, hemocomponents replacements, and nutrition. The total amount of each resource or component used was aggregated and multiplied by the unitary cost, and thus individual cost for each patient was obtained. $ 5,703.22 ± 9,318.68). Conclusion -Total costs on the waiting list for liver transplantation increased according to the patient's severity. Individually, hospitalizations, hemocomponents reposition and hepatocellular carcinoma treatment were the main cost drivers to the patient on the waiting list. The longer the waiting time, the higher the total cost on list, causing greater impact on health systems.

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“…As a general rule, 5-year survival rates for patients with HCC after LR are between 50% and 70% and, after LT, between 70% and 80% (138)(139)(140)(141) . The tumor recurrence rate after LR is around 50% and post-LT around 10% (140)(141)(142)(143) . However, considering the long time spent on the waiting list (over 6-9 months), when an intention-totreat analysis is performed, similar survival outcomes are found when comparing LR with LT (137,144) .…”

Section: Surgical Treatmentmentioning

confidence: 95%

“…However, the evolution of surgical techniques and perioperative care has allowed the expansion of liver surgery indications (47) . Thus, limited LR in patients with preserved liver function, small-sized esophageal varices, and platelet counts above 100,000 is feasible in selected patients with "mild" portal hypertension (138,141,146) . Nevertheless, it is noteworthy that even CP A patients can decompensate after major resections (140) .…”

Section: Surgical Treatmentmentioning

confidence: 99%

Brazilian Society of Hepatology Updated Recommendations for Diagnosis and Treatment of Hepatocellular Carcinoma

Chagas

Mattos

Carrilho

et al. 2020

Arq. Gastroenterol.

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Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.

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IS RESECTION OF HEPATOCELLULAR CARCINOMA IN THE ERA OF LIVER TRANSPLANTATION WORTHWILE? A single center experience

Abstract: - Resection, for selected cases, is a potentially curative treatment with acceptable morbidity and mortality and, in a context of a long waiting list for transplant, plays an important role for the treatment of hepatocellular carcinoma.

Cited by 10 publications

References 47 publications

Liver Resection in Brazil: A National Survey

Liver Resection in Brazil: A National Survey

Higher MELD score increases the overall cost on the waiting list for liver transplantation: a micro-costing analysis based study

Brazilian Society of Hepatology Updated Recommendations for Diagnosis and Treatment of Hepatocellular Carcinoma

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