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Article: Improving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years

TitleImproving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years
Authors
Issue Date2001
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2001, v. 234 n. 1, p. 63-70 How to Cite?
AbstractObjective: To investigate whether the survival results after resection of hepatocellular carcinoma (HCC) have improved within the past decade by an analysis of a prospective cohort of patients over a 10-year period. Summary Background Data: The surgical death rate after resection of HCC has greatly improved in recent years, but the long-term prognosis remains unsatisfactory. It remains unknown whether the survival results after resection of HCC have improved within the past decade. Methods: The clinicopathologic and follow-up data of 377 patients who underwent curative resection of HCC between January 1989 and January 1999 were prospectively collected. These patients were categorized according to two time periods: before 1994 (group 1, n = 136) and after 1994 (group 2, n = 241). The two groups were compared for clinicopathologic data and survival results. The prognostic factors for disease-free survival were further analyzed to identify the factors that might have led to improved survival outcomes. Results: The overall and disease-free survival results were significantly better in group 2 compared with group 1. Patients in group 2 had significantly higher proportions of subclinical presentation, small tumors, and tumors of early pTNM stage. There were also significantly lower frequencies of histologic margin involvement, less intraoperative blood loss, and a lower transfusion rate in group 2. By multivariate analysis, early pTNM stage, subclinical HCC, and no perioperative transfusion were independent favorable prognostic factors for disease-free survival. Conclusions: Significant improvement of overall and disease-free survival results after resection of HCC has been achieved within the past decade as a result of advances in the diagnosis and surgical management of HCC. Earlier diagnosis of HCC by better imaging modalities, increased detection of subclinical HCC by screening of high-risk patients, and a reduced perioperative transfusion rate were identified as the major contributory factors for the improved outcomes.
Persistent Identifierhttp://hdl.handle.net/10722/49420
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2008-06-12T06:42:06Z-
dc.date.available2008-06-12T06:42:06Z-
dc.date.issued2001en_HK
dc.identifier.citationAnnals Of Surgery, 2001, v. 234 n. 1, p. 63-70en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49420-
dc.description.abstractObjective: To investigate whether the survival results after resection of hepatocellular carcinoma (HCC) have improved within the past decade by an analysis of a prospective cohort of patients over a 10-year period. Summary Background Data: The surgical death rate after resection of HCC has greatly improved in recent years, but the long-term prognosis remains unsatisfactory. It remains unknown whether the survival results after resection of HCC have improved within the past decade. Methods: The clinicopathologic and follow-up data of 377 patients who underwent curative resection of HCC between January 1989 and January 1999 were prospectively collected. These patients were categorized according to two time periods: before 1994 (group 1, n = 136) and after 1994 (group 2, n = 241). The two groups were compared for clinicopathologic data and survival results. The prognostic factors for disease-free survival were further analyzed to identify the factors that might have led to improved survival outcomes. Results: The overall and disease-free survival results were significantly better in group 2 compared with group 1. Patients in group 2 had significantly higher proportions of subclinical presentation, small tumors, and tumors of early pTNM stage. There were also significantly lower frequencies of histologic margin involvement, less intraoperative blood loss, and a lower transfusion rate in group 2. By multivariate analysis, early pTNM stage, subclinical HCC, and no perioperative transfusion were independent favorable prognostic factors for disease-free survival. Conclusions: Significant improvement of overall and disease-free survival results after resection of HCC has been achieved within the past decade as a result of advances in the diagnosis and surgical management of HCC. Earlier diagnosis of HCC by better imaging modalities, increased detection of subclinical HCC by screening of high-risk patients, and a reduced perioperative transfusion rate were identified as the major contributory factors for the improved outcomes.en_HK
dc.format.extent388 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsAnnals of Surgery. Copyright © Lippincott Williams & Wilkins.-
dc.subject.meshCarcinoma, Hepatocellular - mortality - surgeryen_HK
dc.subject.meshHepatectomyen_HK
dc.subject.meshLiver Neoplasms - mortality - surgeryen_HK
dc.subject.meshDisease-Free Survivalen_HK
dc.subject.meshMiddle Ageden_HK
dc.titleImproving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 yearsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=234&issue=1&spage=63&epage=70&date=2001&atitle=Improving+survival+results+after+resection+of+hepatocellular+carcinoma:+a+prospective+study+of+377+patients+over+10+yearsen_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hku.hken_HK
dc.identifier.emailLiu, CL: clliu@hkucc.hku.hken_HK
dc.identifier.emailLam, CM: drcmlam@hkma.org-
dc.identifier.emailWong, J: jwong@hkucc.hku.hk-
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1097/00000658-200107000-00010en_HK
dc.identifier.pmid11420484-
dc.identifier.pmcidPMC1421949en_HK
dc.identifier.scopuseid_2-s2.0-0034941503en_HK
dc.identifier.hkuros68571-
dc.identifier.hkuros89272-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034941503&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume234en_HK
dc.identifier.issue1en_HK
dc.identifier.spage63en_HK
dc.identifier.epage70en_HK
dc.identifier.isiWOS:000169700100010-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridLam, CM=36799183200en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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