Renner, Philipp and Schuhbaum, Juergen and Kroemer, Alexander and Zeman, Florian and Loss, Martin and Lang, Sven A. and Geissler, Edward K. and Schlitt, Hans J. and Farkas, Stefan A. (2016) Morbidity of hepatic resection for intermediate and advanced hepatocellular carcinoma. LANGENBECKS ARCHIVES OF SURGERY, 401 (1). pp. 43-53. ISSN 1435-2443, 1435-2451
Full text not available from this repository. (Request a copy)Abstract
According to current treatment guidelines, surgical resection of hepatocellular carcinoma (HCC) is mostly restricted to a limited subgroup of patients. Due to improved surgical techniques and perioperative management, liver resections may also be performed more extendedly and also in cirrhotic livers with clinical signs of portal hypertension in selected patients. In this study, the clinical and long-term outcomes of liver resection in HCC patients with or without liver cirrhosis were evaluated. One hundred fifty-eight patients undergoing liver resection for primary HCC at our institution were identified. Logistic and Cox regression analyses were used to identify prognostic parameters for postoperative complications and survival. In our cohort of patients, there was no association between clinical parameters or extent of surgical resection and postoperative morbidity. Only Barcelona Clinic Liver Cancer (BCLC) stage C patients were at significantly higher risk for major complications (OR 5.27, P = 0.009). Risk factors influencing long-term survival were patient age (HR 1.026, P = 0.027) and BCLC stage C (HR 3.47, P = 0.002). Compared to patients without liver cirrhosis, BCLC stage A and B patients undergoing resection were at similar risk for the development of severe complications and long-term mortality. Liver resection as potentially curative therapy can be performed in selected patients in BCLC stage B, as well as in patients with clinical signs of portal hypertension. The resection of HCC-classified BCLC stage C is feasible but associated with significant morbidity and mortality.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXPERT CONSENSUS STATEMENT; LIVER-FUNCTION; STAGE B; STRATEGIES; DIAGNOSIS; CHEMOEMBOLIZATION; CIRRHOSIS; SURGERY; Hepatocellular carcinoma; BCLC; Liver resection; Liver cancer; Portal hypertension |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 Mar 2019 07:19 |
| Last Modified: | 13 Mar 2019 07:19 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2438 |
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