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Conference Paper: Resection Prior to Liver Transplantation for Hepatocellular Carcinoma

TitleResection Prior to Liver Transplantation for Hepatocellular Carcinoma
Authors
Issue Date2003
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2003, v. 238 n. 6, p. 885-893 How to Cite?
AbstractObjective: To evaluate the feasibility and postoperative course of liver transplantation (LT) in cirrhotic patients who underwent liver resection prior to LT for HCC. Summary Background Data: Although LT provides longer survival than liver resection for treatment of small HCCs, donor shortage and long LT wait time may argue against LT. The feasibility and survival following LT after hepatic resection have not been previously examined. Methods: Between 1991 and 2001, among 107 patients who underwent LT for HCC, 88 met Mazzafero's criteria upon pathologic analysis of the explant. Of these, 70 underwent primary liver transplantation (PLT) and 18 liver resection prior to secondary liver transplantation (SLT) for recurrence (n = 11), deterioration of liver function (n = 4), or high risk for recurrence (n = 3). Perioperative and postoperative factors and long-term survival were compared. Results: Comparison of PLT and SLT groups at the time of LT revealed similar median age (53 vs. 55 years), sex, and etiology of liver disease (alcohol/viral B/C/other). In the SLT group, the mean time between liver resection and listing for LT was 20 months (range 1-84 months). Overall time on LT waiting list of the two groups was similar (3 vs. 5 months). Pathologic analysis after LT revealed similar tumor size (2.2 vs. 2.3 cm) and number (1.6 vs. 1.7). Perioperative and postoperative courses were not different in terms of operative time (551 vs. 530 minutes), blood loss (1191 vs. 1282 mL), transfusion (3 vs. 2 units), ICU (9 vs. 10 days) or hospital stay (32 vs. 31 days), morbidity (51% vs. 56%) or 30-day mortality (5.7% vs. 5.6%). During a median follow-up of 32 months (3 to 158 months), 3 patients recurred after PLT and one after SLT. After transplantation, 3- and 5-year overall survivals were not different between groups (82 vs. 82% and 59 vs. 61%). Conclusions: In selected patients, liver resection prior to transplantation does not increase the morbidity or impair long-term survival following LT. Therefore, liver resection prior to transplantation can be integrated in the treatment strategy for HCC.
Persistent Identifierhttp://hdl.handle.net/10722/173561
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
References

 

DC FieldValueLanguage
dc.contributor.authorBelghiti, Jen_US
dc.contributor.authorCortes, Aen_US
dc.contributor.authorAbdalla, EKen_US
dc.contributor.authorRégimbeau, JMen_US
dc.contributor.authorPrakash, Ken_US
dc.contributor.authorDurand, Fen_US
dc.contributor.authorSommacale, Den_US
dc.contributor.authorDondero, Fen_US
dc.contributor.authorLesurtel, Men_US
dc.contributor.authorSauvanet, Aen_US
dc.contributor.authorFarges, Oen_US
dc.contributor.authorKianmanesh, Ren_US
dc.contributor.authorFan, STen_US
dc.contributor.authorNeuhaus, Pen_US
dc.contributor.authorTranberg, KGen_US
dc.contributor.authorHockerstedt, AVen_US
dc.contributor.authorAdam, RAen_US
dc.date.accessioned2012-10-30T06:32:58Z-
dc.date.available2012-10-30T06:32:58Z-
dc.date.issued2003en_US
dc.identifier.citationAnnals Of Surgery, 2003, v. 238 n. 6, p. 885-893en_US
dc.identifier.issn0003-4932en_US
dc.identifier.urihttp://hdl.handle.net/10722/173561-
dc.description.abstractObjective: To evaluate the feasibility and postoperative course of liver transplantation (LT) in cirrhotic patients who underwent liver resection prior to LT for HCC. Summary Background Data: Although LT provides longer survival than liver resection for treatment of small HCCs, donor shortage and long LT wait time may argue against LT. The feasibility and survival following LT after hepatic resection have not been previously examined. Methods: Between 1991 and 2001, among 107 patients who underwent LT for HCC, 88 met Mazzafero's criteria upon pathologic analysis of the explant. Of these, 70 underwent primary liver transplantation (PLT) and 18 liver resection prior to secondary liver transplantation (SLT) for recurrence (n = 11), deterioration of liver function (n = 4), or high risk for recurrence (n = 3). Perioperative and postoperative factors and long-term survival were compared. Results: Comparison of PLT and SLT groups at the time of LT revealed similar median age (53 vs. 55 years), sex, and etiology of liver disease (alcohol/viral B/C/other). In the SLT group, the mean time between liver resection and listing for LT was 20 months (range 1-84 months). Overall time on LT waiting list of the two groups was similar (3 vs. 5 months). Pathologic analysis after LT revealed similar tumor size (2.2 vs. 2.3 cm) and number (1.6 vs. 1.7). Perioperative and postoperative courses were not different in terms of operative time (551 vs. 530 minutes), blood loss (1191 vs. 1282 mL), transfusion (3 vs. 2 units), ICU (9 vs. 10 days) or hospital stay (32 vs. 31 days), morbidity (51% vs. 56%) or 30-day mortality (5.7% vs. 5.6%). During a median follow-up of 32 months (3 to 158 months), 3 patients recurred after PLT and one after SLT. After transplantation, 3- and 5-year overall survivals were not different between groups (82 vs. 82% and 59 vs. 61%). Conclusions: In selected patients, liver resection prior to transplantation does not increase the morbidity or impair long-term survival following LT. Therefore, liver resection prior to transplantation can be integrated in the treatment strategy for HCC.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_US
dc.relation.ispartofAnnals of Surgeryen_US
dc.titleResection Prior to Liver Transplantation for Hepatocellular Carcinomaen_US
dc.typeConference_Paperen_US
dc.identifier.emailFan, ST: stfan@hku.hken_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-0842289167en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0842289167&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume238en_US
dc.identifier.issue6en_US
dc.identifier.spage885en_US
dc.identifier.epage893en_US
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridBelghiti, J=35403099400en_US
dc.identifier.scopusauthoridCortes, A=7102091663en_US
dc.identifier.scopusauthoridAbdalla, EK=7006112354en_US
dc.identifier.scopusauthoridRégimbeau, JM=7003436804en_US
dc.identifier.scopusauthoridPrakash, K=7102320104en_US
dc.identifier.scopusauthoridDurand, F=7102160406en_US
dc.identifier.scopusauthoridSommacale, D=6602095304en_US
dc.identifier.scopusauthoridDondero, F=7006584084en_US
dc.identifier.scopusauthoridLesurtel, M=6603454412en_US
dc.identifier.scopusauthoridSauvanet, A=7005450991en_US
dc.identifier.scopusauthoridFarges, O=7006305970en_US
dc.identifier.scopusauthoridKianmanesh, R=6701430799en_US
dc.identifier.scopusauthoridFan, ST=7402678224en_US
dc.identifier.scopusauthoridNeuhaus, P=13702651800en_US
dc.identifier.scopusauthoridTranberg, KG=7005277812en_US
dc.identifier.scopusauthoridHockerstedt, AV=6506264237en_US
dc.identifier.scopusauthoridAdam, RA=7202478918en_US

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