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Article: Role of portal vein embolization in hepatocellular carcinoma management and its effect on recurrence: A case-control study

TitleRole of portal vein embolization in hepatocellular carcinoma management and its effect on recurrence: A case-control study
Authors
KeywordsMedicine & Public Health
Surgery
Abdominal Surgery
Cardiac Surgery
General Surgery
Thoracic Surgery
Vascular Surgery
Issue Date2012
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 2012, v. 36 n. 7, p. 1640-1646 How to Cite?
AbstractBackground Liver regeneration that occurs after portal vein embolization (PVE) may have adverse effects on the microscopic tumor foci in the residual liver mass in patients with hepatocellular carcinoma (HCC). Methods Fifty-four HCC patients with inadequate functional residual liver volume were offered PVE during a seven-year period. Among them, 34 (63%) patients underwent curative resection. They were compared with a matched control group (n = 102) who underwent surgery without PVE. Postoperative complications, pattern of recurrence, and survival were compared between groups. Results In the PVE group, a pre-embolization functional residual liver volume of 23% (12-33.5%) improved to 34% (20-54%) (p = 0.005) at the time of surgery. When the two groups were compared, minor (PVE, 24%; control, 29%; p = 0.651) and major (PVE, 18%; control, 15%; p = 0.784) complications were similar. After a follow-up period of 35 months (standard deviation 25 months), extrahepatic recurrences were detected in 10 PVE patients (29%) and 41 control patients (40%) (p = 0.310). Intrahepatic recurrences were seen in 10 (29%) and 47 (46%) cases (p = 0.109) in the PVE and control groups, respectively. In the PVE group, 41% (n = 14) of the recurrences were detected before one year, compared with 42% (n = 43) in the control group (p = 1). Disease-free survival rates at 1, 3, and 5 years were 57, 29, and 26% in the control group and 60, 42, and 42% in the PVE group (log-rank, p = 0.335). On multivariate analysis, PVE was not a factor affecting survival (p = 0.821). Conclusions Portal vein embolization increases the resectability of initially unresectable HCC due to inadequate functional residual liver volume, and it has no deleterious oncological effect after major resection of HCC. © The Author(s) 2012.
Persistent Identifierhttp://hdl.handle.net/10722/147108
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSiriwardana, RCen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2012-05-28T08:17:29Z-
dc.date.available2012-05-28T08:17:29Z-
dc.date.issued2012en_HK
dc.identifier.citationWorld Journal Of Surgery, 2012, v. 36 n. 7, p. 1640-1646en_HK
dc.identifier.issn0364-2313en_HK
dc.identifier.urihttp://hdl.handle.net/10722/147108-
dc.description.abstractBackground Liver regeneration that occurs after portal vein embolization (PVE) may have adverse effects on the microscopic tumor foci in the residual liver mass in patients with hepatocellular carcinoma (HCC). Methods Fifty-four HCC patients with inadequate functional residual liver volume were offered PVE during a seven-year period. Among them, 34 (63%) patients underwent curative resection. They were compared with a matched control group (n = 102) who underwent surgery without PVE. Postoperative complications, pattern of recurrence, and survival were compared between groups. Results In the PVE group, a pre-embolization functional residual liver volume of 23% (12-33.5%) improved to 34% (20-54%) (p = 0.005) at the time of surgery. When the two groups were compared, minor (PVE, 24%; control, 29%; p = 0.651) and major (PVE, 18%; control, 15%; p = 0.784) complications were similar. After a follow-up period of 35 months (standard deviation 25 months), extrahepatic recurrences were detected in 10 PVE patients (29%) and 41 control patients (40%) (p = 0.310). Intrahepatic recurrences were seen in 10 (29%) and 47 (46%) cases (p = 0.109) in the PVE and control groups, respectively. In the PVE group, 41% (n = 14) of the recurrences were detected before one year, compared with 42% (n = 43) in the control group (p = 1). Disease-free survival rates at 1, 3, and 5 years were 57, 29, and 26% in the control group and 60, 42, and 42% in the PVE group (log-rank, p = 0.335). On multivariate analysis, PVE was not a factor affecting survival (p = 0.821). Conclusions Portal vein embolization increases the resectability of initially unresectable HCC due to inadequate functional residual liver volume, and it has no deleterious oncological effect after major resection of HCC. © The Author(s) 2012.en_HK
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_HK
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.rightsThe Author(s)en_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.subjectMedicine & Public Healthen_US
dc.subjectSurgeryen_US
dc.subjectAbdominal Surgeryen_US
dc.subjectCardiac Surgeryen_US
dc.subjectGeneral Surgeryen_US
dc.subjectThoracic Surgeryen_US
dc.subjectVascular Surgeryen_US
dc.titleRole of portal vein embolization in hepatocellular carcinoma management and its effect on recurrence: A case-control studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://www.springerlink.com/link-out/?id=2104&code=VR240Q5X780Q3165&MUD=MPen_US
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1007/s00268-012-1522-3en_HK
dc.identifier.pmid22411084-
dc.identifier.scopuseid_2-s2.0-84864285237en_HK
dc.identifier.hkuros211075-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84864285237&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume36en_HK
dc.identifier.issue7en_HK
dc.identifier.spage1640en_HK
dc.identifier.epage1646en_HK
dc.identifier.eissn1432-2323en_US
dc.identifier.isiWOS:000304880600024-
dc.publisher.placeUnited Statesen_HK
dc.description.otherSpringer Open Choice, 28 May 2012en_US
dc.identifier.scopusauthoridSiriwardana, RC=35321203400en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridChan, SC=36901164300en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.citeulike10480226-

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