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Article: Continuous improvement of survival outcomes of resection of hepatocellular carcinoma: A 20-year experience

TitleContinuous improvement of survival outcomes of resection of hepatocellular carcinoma: A 20-year experience
Authors
Issue Date2011
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2011, v. 253 n. 4, p. 745-758 How to Cite?
AbstractObjective: To investigate the trend of the posthepatectomy survival outcomes of hepatocellular carcinoma (HCC) patients by analysis of a prospective cohort of 1198 patients over a 20-year period. Background: The hospital mortality rate of hepatectomy for HCC has improved but the long-term survival rate remains unsatisfactory. We reported an improvement of survival results 10 years ago. It was not known whether there has been further improvement of results in recent years. Methods: The patients were categorized into two 10-year periods: period 1, before 1999 (group 1, n = 390) and period 2, after 1999 (group 2, n = 808). Patients in group 2 were managed according to a modified protocol and technique established in previous years. Results: The patients in group 2 were older and had a higher incidence of comorbid illness and cirrhosis. They had a lower hospital mortality rate (3.1% vs 6.2%, P = 0.012) and longer 5-year overall survival (54.8% vs 42.1%, P < 0.001) and disease-free survival rates (34.8% vs 24%, P = 0.0024). An improvement in the overall survival rate was observed in patients with cirrhosis, those undergoing major hepatectomy, and those with tumors of tumor-node-metastasis stages II, IIIA, and IVA. A significant increase in the survival rates was also seen in patients whose tumors were considered transplantable by the Milan criteria (72.5% vs 62.7%, P = 0.0237). Multivariate analysis showed a significantly more favorable patient survival for hepatectomy in period 2. Conclusions: A continuous improvement of survival outcomes after hepatectomy for HCC was achieved in the past 20 years even in patients with advanced diseases. Hepatectomy remains the treatment of choice for resectable HCC in a predominantly hepatitis B virus-based Asian population. © 2011 Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/135539
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFan, STen_HK
dc.contributor.authorMau Lo, Cen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorYeung, Cen_HK
dc.contributor.authorLeung Liu, Cen_HK
dc.contributor.authorYuen, WKen_HK
dc.contributor.authorMing Lam, Cen_HK
dc.contributor.authorNg, KKCen_HK
dc.contributor.authorChing Chan, Sen_HK
dc.date.accessioned2011-07-27T01:36:43Z-
dc.date.available2011-07-27T01:36:43Z-
dc.date.issued2011en_HK
dc.identifier.citationAnnals Of Surgery, 2011, v. 253 n. 4, p. 745-758en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135539-
dc.description.abstractObjective: To investigate the trend of the posthepatectomy survival outcomes of hepatocellular carcinoma (HCC) patients by analysis of a prospective cohort of 1198 patients over a 20-year period. Background: The hospital mortality rate of hepatectomy for HCC has improved but the long-term survival rate remains unsatisfactory. We reported an improvement of survival results 10 years ago. It was not known whether there has been further improvement of results in recent years. Methods: The patients were categorized into two 10-year periods: period 1, before 1999 (group 1, n = 390) and period 2, after 1999 (group 2, n = 808). Patients in group 2 were managed according to a modified protocol and technique established in previous years. Results: The patients in group 2 were older and had a higher incidence of comorbid illness and cirrhosis. They had a lower hospital mortality rate (3.1% vs 6.2%, P = 0.012) and longer 5-year overall survival (54.8% vs 42.1%, P < 0.001) and disease-free survival rates (34.8% vs 24%, P = 0.0024). An improvement in the overall survival rate was observed in patients with cirrhosis, those undergoing major hepatectomy, and those with tumors of tumor-node-metastasis stages II, IIIA, and IVA. A significant increase in the survival rates was also seen in patients whose tumors were considered transplantable by the Milan criteria (72.5% vs 62.7%, P = 0.0237). Multivariate analysis showed a significantly more favorable patient survival for hepatectomy in period 2. Conclusions: A continuous improvement of survival outcomes after hepatectomy for HCC was achieved in the past 20 years even in patients with advanced diseases. Hepatectomy remains the treatment of choice for resectable HCC in a predominantly hepatitis B virus-based Asian population. © 2011 Lippincott Williams & Wilkins.en_HK
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsThis is a non-final version of an article published in final form in Annals of Surgery, 2011, v. 253 n. 4, p. 745-758-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAge Factors-
dc.subject.meshCarcinoma, Hepatocellular - mortality - pathology - surgery-
dc.subject.meshHepatectomy - methods - mortality-
dc.subject.meshLiver Neoplasms - mortality - pathology - surgery-
dc.subject.meshNeoplasm Recurrence, Local - mortality - pathology-
dc.titleContinuous improvement of survival outcomes of resection of hepatocellular carcinoma: A 20-year experienceen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=253&issue=4&spage=745&epage=758&date=2011&atitle=Continuous+improvement+of+survival+outcomes+of+resection+of+hepatocellular+carcinoma:+a+20-year+experience-
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailMau Lo, C: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.emailChing Chan, S: chanlsc@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityMau Lo, C=rp00412en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityChing Chan, S=rp01568en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1097/SLA.0b013e3182111195en_HK
dc.identifier.pmid21475015-
dc.identifier.scopuseid_2-s2.0-79953174883en_HK
dc.identifier.hkuros187629en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79953174883&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume253en_HK
dc.identifier.issue4en_HK
dc.identifier.spage745en_HK
dc.identifier.epage758en_HK
dc.identifier.isiWOS:000288368600016-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridMau Lo, C=7401771672en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridYeung, C=26531966700en_HK
dc.identifier.scopusauthoridLeung Liu, C=37061372800en_HK
dc.identifier.scopusauthoridYuen, WK=7102761292en_HK
dc.identifier.scopusauthoridMing Lam, C=37061757800en_HK
dc.identifier.scopusauthoridNg, KKC=7403179075en_HK
dc.identifier.scopusauthoridChing Chan, S=7404255575en_HK

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