Risk Factors Influencing Postoperative Outcomes of Major Hepatic Resection of Hepatocellular Carcinoma for Patients with Underlying Liver Diseases

Yang, Tian; Zhang, Jin; Lü, Junhua; Yang, Guang-Shun; Wu, Mengchao; Yu, Weifeng

doi:10.1007/s00268-011-1161-0

Cited by 175 publications

(149 citation statements)

References 55 publications

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“…The measurement of tumor-specific biological markers can be useful after curative treatments, and it is, therefore, necessary to identify new markers. In addition to tumor-specific markers, liver function, surgical records or outcomes might be closely related to the prognosis of HCC patients after hepatectomy [6][7][8]. We reported that non-tumor related parameters, such as hepatic fibrosis and postoperative long-term ascites, were associated with poor survival [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Some factors associated with patient survival have been identified [3][4][5]. Markers of poor hepatic function and tumor-related factors are significantly associated with tumor recurrence and lower survival [6][7][8]. Our previous study showed that an advanced grade of hepatic fibrosis, hepatitis, postoperative long-term ascites or postoperative levels of alpha-feto protein (a marker of chronic hepatitis) were significantly associated with shorter survival due to carcinoma after hepatectomy [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Serum Hyaluronic Acid Level and Patient Prognosis in Hepatocellular Carcinoma Patients Who Underwent Hepatectomy

Nanashima¹,

Abo²,

Murakami³

et al. 2013

JCT

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We examined the relationship between hyaluronic acid (HA) and tumor-related factors after hepatectomy in 158 patients with hepatocellular carcinoma (HCC) who underwent hepatectomy. We examined serum HA levels before hepatectomy by evaluating data for clinicopathological parameters, surgical records, postoperative complications and survival. The mean HA level was 190 ± 202 ng/ml. Patients were divided into 3 groups: group A had serum HA levels less than 50 ng/ml (normal range), group B had levels between 50 and 190 ng/ml, and group C had levels over 190 ng/ml. Group C had a higher rate of poor liver function compared to others. Multiple tumors were significantly more frequent in groups B and C compared to A. The grade of fibrosis and the inflammatory responses were positively correlated with the serum HA level. Postoperative long-term ascites was significantly more frequent in group C compared to others. Although the recurrence rate and the relapse-free period were not significantly related to the serum HA level, the serum HA level was significantly associated with overall survival after hepatectomy (p < 0.05). Cox's multivariate analysis did not show a significant relationship between HA level and survival. Serum HA reflects progression and survival in HCC patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship between Serum Hyaluronic Acid Level and Patient Prognosis in Hepatocellular Carcinoma Patients Who Underwent Hepatectomy

Nanashima¹,

Abo²,

Murakami³

et al. 2013

JCT

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“…The rate and amount of PRBCs transfused in patients undergoing liver resections ranges between 8.7% and 85.7% and from 0 to 24 units, respectively [12,[56][57][58][59][60]. In a large series of patients, Katz et al reported that only 18% of patients received blood transfusion [103].…”

Section: Liver Resections and Combined Multivisceral Oncologicmentioning

confidence: 99%

“…Reported estimated blood loss [38][39][40][41][42][43] 400-12,100 2-10 Sacral tumors [44][45][46] 3,000-37,000 0-43 Hemipelvectomy [47][48][49][50] 400-12,100 0-134 Total pelvic exenterations [47][48][49][50] 900-9,500 0-18 Nephrectomy with IVC embolectomy [37,[51][52][53][54][55] 200−16,000 0−91 Liver and multivisceral resection [12,[56][57][58][59][60][61][62] 200->5,000 0-44 Extrapleural pneumonectomies [63][64][65] 900-65,00 0-18 Table 1 illustrates ranges of blood losses and PRBCs of transfused units reported in the literature.…”

Section: Nephrectomy With Inferior Venous Cava Thrombectomymentioning

confidence: 99%

“…Understandably, hemorrhage and blood transfusion during liver resections have an important impact on postoperative morbidity and mortality [21,102,104]. For instance, blood loss higher than 800 cc is an independent risk factor (odd ratio 1.907) for postoperative morbidity after liver resection [57]. Katz et al have also reported that estimated blood loss of more than 1 L was an independent predictor of overall survival (odds ratio −2.2), recurrence free survival (odds ratio −1.7), and disease-specific survival (odds ratio −2.3) [103].…”

Section: Liver Resections and Combined Multivisceral Oncologicmentioning

confidence: 99%

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Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

Cata

Gottumukkala

2012

ISRN Anesthesiology

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Patients with solid malignancies who were not candidates for tumor resections in the past are now presenting for extensive oncological resections. Cancer patients are at risk for thromboembolic complications due to an underlying hypercoagulable state; however, some patients may have an increased risk for bleeding due to the effects of chemotherapy, the administration of anticoagulant drugs, tumor-related fibrinolysis, tumor location, tumor vascularity, and extent of disease. A common potential complication of all complex oncological surgeries is massive intra-and postoperative hemorrhage and the subsequent risk for massive blood transfusion. This can be anticipated or unexpected. Several surgical and anesthesia interventions including preoperative tumor embolization, major vessel occlusion, hemodynamic manipulation, and perioperative antifibrinolytic therapy have been used to prevent or control blood loss with varying success. The exact incidence of massive blood transfusion in oncological surgery is largely unknown and/or underreported. The current literature mostly consists of purely descriptive observational studies. Thus, recommendation regarding specific perioperative intervention cannot be made at this point, and more research is warranted.

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Treatment strategy for isolated bile leakage after hepatectomy: Literature review

Kubo

Shirabe

2019

Annals of Gastroent Surgery

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Isolated bile leakage (IBL) after hepatectomy is intractable, and various treatment methods for it have been reported. This review aimed to clarify the treatment strategy for IBL by summarizing studies on IBL after hepatectomy without extrahepatic bile duct resection. Thirty‐three cases of IBL were reported. The incidence of IBL is very low, accounting for 0.1%–1% of all hepatectomy cases. The risk factors for IBL are unclear; however, several reports mention that biliary anomaly is associated with a high risk of IBL, with preoperative and intraoperative confirmation of biliary tree anatomy being the most important preventive strategy. Treatment methods for IBL include liver resection, bilioenteric anastomosis, endoscopic treatment, bile duct ablation, percutaneous transhepatic portal vein embolization (PTPE), transcatheter arterial embolization, and use of fibrin glue. The therapeutic methods should be chosen depending on remnant liver function, amount of bile leakage, and the liver volume causing the bile leakage. When there is bile leakage from less than one segment, non‐surgical treatment is recommended, whereas when there is bile leakage from one or more segments, surgical treatment can be recommended. Nevertheless, recently, non‐surgical treatment such as PTPE, PTPE with bile duct ablation, and endoscopic methods have been considered as effective treatment approaches.

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Risk Factors Influencing Postoperative Outcomes of Major Hepatic Resection of Hepatocellular Carcinoma for Patients with Underlying Liver Diseases

Cited by 175 publications

References 55 publications

Relationship between Serum Hyaluronic Acid Level and Patient Prognosis in Hepatocellular Carcinoma Patients Who Underwent Hepatectomy

Relationship between Serum Hyaluronic Acid Level and Patient Prognosis in Hepatocellular Carcinoma Patients Who Underwent Hepatectomy

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

Treatment strategy for isolated bile leakage after hepatectomy: Literature review

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