Surgical outcome of hepatocellular carcinoma patients with biliary tumor thrombi

Abstract

BackgroundTo investigate the surgical outcome of hepatocellular carcinoma (HCC) patients with biliary tumor thrombi (BTT).MethodsSurgical outcome of 27 HCC patients with BTT (group I) were compared with randomly selected HCC patients without BTT (group II; n = 270).ResultsOne patient in group I died of hepatic failure within 30 days after resection. The 1-, 3- and 5-year cumulative survival rates of group I were 70.3%, 25.9%, and 7.4%, respectively; these were significantly lower than those of group II (90.6%, 54.0%, and 37.7%) (P <0.001). The rates of early recurrence (≤ 1 year) after resection were significantly higher in group I than group II (70.3% vs. 34.8%) (P < 0.001).ConclusionHCC patients with BTT had a worse prognosis after resection than those without BTT. Resection should be considered for these tumors given the lack of effective alternative therapies.

Outcomes of hepatectomy for hepatocellular carcinoma with bile duct tumour thrombus

“…Bile duct recurrence did not occur in those who had HJ. This was in great contrast to a previous report that major hepatectomy and HJ were not a routine and an early recurrence rate (<1 year after hepatectomy) of 70.3% and bile duct recurrence rate of 22.2% were observed . The present study has demonstrated that even with an aggressive surgical approach, there was no difference in hospital mortality (2.7% versus 5%, P = 0.856) but only a higher morbidity (51.4% versus 31.3%, P = 0.016).…”

“…There is controversy whether HCC with BDTT has the same outcomes after hepatectomy as HCC without BDTT . Besides prognosis, evidence is lacking on the preferred method for biliary drainage, extent of hepatectomy and the need for extrahepatic bile duct resection and hepaticojejunostomy (HJ) in these patients . The aim of this study was to review the pathological characteristics of HCC with BDTT and the outcomes of these tumours after a hepatectomy.…”

Bile duct thrombi in hepatocellular carcinoma: is aggressive surgery worthwhile?

“…found no significant differences in survival between patients with BDTT and those without BDTT . On the other hand, recent studies including ours, have observed significantly poorer survival outcomes in patients with BDTT after surgery …”

“…The outcome in patients who receive palliative treatment is uniformly dismal, with a mean survival time of less than 5 months. [8][9][10][11] For HCC patients with BDTT, surgical resection is the only option for curative treatment, increasing the chance of survival.…”

Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion

“…Some previous studies reported poorer surgical outcomes in these patients than in those without bile duct invasion [13,15,31,32]. However, others have reported that some patients with obstructive jaundice can be treated by hepatic resection, with favorable long-term results [7,10,14,26,33].…”