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Article: Tumor size and operative risks of extended right-sided hepatic resection for hepatocellular carcinoma: Implication for preoperative portal vein embolization

TitleTumor size and operative risks of extended right-sided hepatic resection for hepatocellular carcinoma: Implication for preoperative portal vein embolization
Authors
Issue Date2007
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 2007, v. 142 n. 1, p. 63-69 How to Cite?
AbstractHypothesis: Major hepatic resection for hepatocellular carcinoma (HCC) is associated with high operative morbidity and mortality, especially in patients with underlying chronic liver disease. The present study evaluated the factors associated with increased operative risks in patients who underwent extended right-sided hepatic resection for HCC. Design: Retrospective study. Setting: Tertiary referral center. Patients: A retrospective study was performed on 172 patients who underwent extended right-sided hepatic resection of more than 4 Couinaud segments for HCC during a 16-year period (January 1, 1989, to December 31, 2004) to evaluate the clinical factors associated with operative morbidity and mortality. Main Outcome Measure: Risk factors associated with hospital mortality and major operative morbidity. Results: The overall major morbidity and hospital mortality rates were 14.0% and 8.1%, respectively. On multivariate analysis, small tumor size, conventional-approach hepatectomy, Child-Pugh grade B cirrhosis, and preexisting tumor rupture were the independent factors significantly associated with an increased risk of operative mortality. Discriminant analysis showed that a tumor size smaller than 10 cm significantly increased the risk of operative mortality compared with larger tumors (17.2% vs 3.5%;P=.046). Conclusions: Anterior approach is the preferred technique for extended right-sided hepatic resection for HCC. Increased risk of operative mortality was identified in patients who had a small tumor, which was associated with the resection of a large volume of functioning liver parenchyma. Preoperative portal vein embolization should be considered in this group of patients to enhance atrophy of the right lobe and hypertrophy of the future liver remnant to minimize the operative risk. ©2007 American Medical Association. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/84366
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChik, BHen_HK
dc.contributor.authorChi, LLen_HK
dc.contributor.authorSheung, TFen_HK
dc.contributor.authorChung, MLen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorChi, MLen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:52:06Z-
dc.date.available2010-09-06T08:52:06Z-
dc.date.issued2007en_HK
dc.identifier.citationArchives Of Surgery, 2007, v. 142 n. 1, p. 63-69en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84366-
dc.description.abstractHypothesis: Major hepatic resection for hepatocellular carcinoma (HCC) is associated with high operative morbidity and mortality, especially in patients with underlying chronic liver disease. The present study evaluated the factors associated with increased operative risks in patients who underwent extended right-sided hepatic resection for HCC. Design: Retrospective study. Setting: Tertiary referral center. Patients: A retrospective study was performed on 172 patients who underwent extended right-sided hepatic resection of more than 4 Couinaud segments for HCC during a 16-year period (January 1, 1989, to December 31, 2004) to evaluate the clinical factors associated with operative morbidity and mortality. Main Outcome Measure: Risk factors associated with hospital mortality and major operative morbidity. Results: The overall major morbidity and hospital mortality rates were 14.0% and 8.1%, respectively. On multivariate analysis, small tumor size, conventional-approach hepatectomy, Child-Pugh grade B cirrhosis, and preexisting tumor rupture were the independent factors significantly associated with an increased risk of operative mortality. Discriminant analysis showed that a tumor size smaller than 10 cm significantly increased the risk of operative mortality compared with larger tumors (17.2% vs 3.5%;P=.046). Conclusions: Anterior approach is the preferred technique for extended right-sided hepatic resection for HCC. Increased risk of operative mortality was identified in patients who had a small tumor, which was associated with the resection of a large volume of functioning liver parenchyma. Preoperative portal vein embolization should be considered in this group of patients to enhance atrophy of the right lobe and hypertrophy of the future liver remnant to minimize the operative risk. ©2007 American Medical Association. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.titleTumor size and operative risks of extended right-sided hepatic resection for hepatocellular carcinoma: Implication for preoperative portal vein embolizationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-0010&volume=142&issue=1&spage=63&epage=69&date=2007&atitle=Tumor+size+and+operative+risks+of+extended+right-sided+hepatic+resection+for+hepatocellular+carcinoma:+implication+for+preoperative+portal+vein+embolizationen_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1001/archsurg.142.1.63en_HK
dc.identifier.pmid17224502-
dc.identifier.scopuseid_2-s2.0-33846219833en_HK
dc.identifier.hkuros125965en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33846219833&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume142en_HK
dc.identifier.issue1en_HK
dc.identifier.spage63en_HK
dc.identifier.epage69en_HK
dc.identifier.isiWOS:000243510000013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChik, BH=15764573900en_HK
dc.identifier.scopusauthoridChi, LL=7409789712en_HK
dc.identifier.scopusauthoridSheung, TF=6506234707en_HK
dc.identifier.scopusauthoridChung, ML=8696033300en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridChi, ML=8343493900en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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