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Article: Outcome after partial hepatectomy for hepatocellular cancer within the Milan criteria

TitleOutcome after partial hepatectomy for hepatocellular cancer within the Milan criteria
Authors
Issue Date2011
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uk
Citation
British Journal Of Surgery, 2011, v. 98 n. 9, p. 1292-1300 How to Cite?
AbstractBackground: There is a trend to offer liver transplantation to patients with hepatocellular carcinoma (HCC) with tumour status within the Milan criteria but with preserved liver function. This study aimed to evaluate the outcome of such patients following partial hepatectomy as primary treatment. Methods: A retrospective analysis was performed on all adult patients with HCC and tumour status within the Milan criteria undergoing partial hepatectomy at a single centre from 1995 to 2008. Their outcomes were compared with those of similar patients having right-lobe living donor liver transplantation (LDLT) as primary treatment. Results: A total of 408 patients with HCC were enrolled. Some 384 patients with a solitary tumour 5 cm or less in diameter had a better 5-year survival rate than 24 patients with oligonodular tumours (2-3 nodules, each 3 cm or less in size) (70·7 versus 46 per cent; P = 0·025). Multivariable analysis identified younger age (65 years or less), lack of postoperative complications, negative resection margin, absent microvascular invasion and non-cirrhotic liver as predictors of favourable overall survival. The 5-year survival rate of 287 younger patients with chronic liver disease and R0 hepatectomy was 72·8 per cent, comparable to that of 81 per cent in 50 similar patients treated by LDLT (P = 0·093). Conclusion: Partial hepatectomy for patients with HCC and tumour status within the Milan criteria achieved a satisfactory 5-year survival rate, particularly in younger patients with solitary tumours and R0 hepatectomy. Patients with oligonodular tumours have a worse survival and might benefit from liver transplantation. © 2011 British Journal of Surgery Society Ltd. Published by John Wiley and Sons Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/135523
ISSN
2015 Impact Factor: 5.596
2015 SCImago Journal Rankings: 2.966
ISI Accession Number ID
Funding AgencyGrant Number
Sun Chieh Yeh Research Foundation for Hepatobiliary and Pancreatic Surgery, University of Hong Kong
Funding Information:

The authors thank Mr Henry Tam for assistance with the statistical analysis. This work was funded by the Sun Chieh Yeh Research Foundation for Hepatobiliary and Pancreatic Surgery, University of Hong Kong. The authors declare no conflict of interest.

References

 

DC FieldValueLanguage
dc.contributor.authorFan, STen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorYeung, Cen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorYuen, WKen_HK
dc.contributor.authorNg, KKCen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorChan, SCen_HK
dc.date.accessioned2011-07-27T01:36:29Z-
dc.date.available2011-07-27T01:36:29Z-
dc.date.issued2011en_HK
dc.identifier.citationBritish Journal Of Surgery, 2011, v. 98 n. 9, p. 1292-1300en_HK
dc.identifier.issn0007-1323en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135523-
dc.description.abstractBackground: There is a trend to offer liver transplantation to patients with hepatocellular carcinoma (HCC) with tumour status within the Milan criteria but with preserved liver function. This study aimed to evaluate the outcome of such patients following partial hepatectomy as primary treatment. Methods: A retrospective analysis was performed on all adult patients with HCC and tumour status within the Milan criteria undergoing partial hepatectomy at a single centre from 1995 to 2008. Their outcomes were compared with those of similar patients having right-lobe living donor liver transplantation (LDLT) as primary treatment. Results: A total of 408 patients with HCC were enrolled. Some 384 patients with a solitary tumour 5 cm or less in diameter had a better 5-year survival rate than 24 patients with oligonodular tumours (2-3 nodules, each 3 cm or less in size) (70·7 versus 46 per cent; P = 0·025). Multivariable analysis identified younger age (65 years or less), lack of postoperative complications, negative resection margin, absent microvascular invasion and non-cirrhotic liver as predictors of favourable overall survival. The 5-year survival rate of 287 younger patients with chronic liver disease and R0 hepatectomy was 72·8 per cent, comparable to that of 81 per cent in 50 similar patients treated by LDLT (P = 0·093). Conclusion: Partial hepatectomy for patients with HCC and tumour status within the Milan criteria achieved a satisfactory 5-year survival rate, particularly in younger patients with solitary tumours and R0 hepatectomy. Patients with oligonodular tumours have a worse survival and might benefit from liver transplantation. © 2011 British Journal of Surgery Society Ltd. Published by John Wiley and Sons Ltd.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uken_HK
dc.relation.ispartofBritish Journal of Surgeryen_HK
dc.rightsBritish Journal of Surgery. Copyright © John Wiley & Sons Ltd.-
dc.subject.meshCarcinoma, Hepatocellular - mortality - surgery-
dc.subject.meshChronic Disease-
dc.subject.meshDisease-Free Survival-
dc.subject.meshHepatectomy - methods - mortality-
dc.subject.meshLiver Neoplasms - mortality - surgery-
dc.titleOutcome after partial hepatectomy for hepatocellular cancer within the Milan criteriaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0007-1323&volume=89&issue=9&spage=1292&epage=1300&date=2011&atitle=Outcome+after+partial+hepatectomy+for+hepatocellular+cancer+within+the+Milan+criteria-
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/bjs.7583en_HK
dc.identifier.pmid21656513-
dc.identifier.scopuseid_2-s2.0-79960780934en_HK
dc.identifier.hkuros187494en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79960780934&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume98en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1292en_HK
dc.identifier.epage1300en_HK
dc.identifier.isiWOS:000294355000017-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridYeung, C=26531966700en_HK
dc.identifier.scopusauthoridLam, CM=7402989820en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridYuen, WK=7102761292en_HK
dc.identifier.scopusauthoridNg, KKC=7403179075en_HK
dc.identifier.scopusauthoridLiu, CL=53264492100en_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK

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