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Article: Hepatic resection for incidentaloma

TitleHepatic resection for incidentaloma
Authors
KeywordsHepatic resection
Hepatocellular carcinoma
Liver tumors
Survival outcomes
Issue Date2004
PublisherSpringer New York LLC.
Citation
Journal Of Gastrointestinal Surgery, 2004, v. 8 n. 7, p. 785-793 How to Cite?
AbstractThe study goal was to review a single-center experience in hepatic resection for patients who presented with incidental liver tumors. With recent advances in diagnostic imaging techniques, incidental finding of liver tumors, or "incidentalomas," is increasing in asymptomatic and healthy individuals. However, little information is available in the literature regarding the underlying pathology and operative outcomes after hepatic resection. Between January 1989 and December 2002, 1011 patients underwent hepatic resection for liver tumors; of these patients, 107 (11%) were asymptomatic individuals who presented with incidentalomas. Incidentalomas were first detected on percutaneous ultrasonography (n = 83), computed tomography (n = 23), or magnetic resonance imaging (n = 1). Fifteen (14%) patients had preoperative aspiration for cytology or biopsy for histology, and the results correlated with the final pathology in 12 patients. Fifty-six (52%) patients underwent major hepatic resection with resection of three or more Coiunaud's segments. Median postoperative hospital stay was 8 days (range, 3-66 days). The operative mortality rate was 1%, and the operative morbidity rate was 21%. Histologic examination of the resected specimen revealed malignant liver tumors in 62 (58%) patients, including hepatocellular carcinoma (HCC) (n = 48), cholangiocarcinoma (n = 8), lymphoma (n = 2), cystadenocarcinoma (n = 2), carcinoid tumor (n = 1), and malignant fibrous histiocytoma (n = 1). Benign pathologies were found in 45 (42%) patients, including focal nodular hyperplasia (n = 17), hemangioma (n = 12), angiomyolipoma (n = 5), cirrhotic regenerative nodule (n = 4), hepatic adenoma (n = 2), and others (n = 5). On multivariate analysis, male sex, age of greater than 50 years, and tumor size of greater than 4 cm were the independent predictive factors for malignant diseases. On retrospective analysis, 48 patients with HCC who presented with incidentalomas had significantly better survival outcomes after hepatic resection than did 646 patients with HCC who presented otherwise during the same study period. Hepatic resection for patients with incidentalomas is associated with a low operative mortality and acceptable morbidity. The diagnosis of malignant disease, especially HCC, should be considered in male patients older than 50 years who present with large hepatic lesions. © 2004 The Society for Surgery of the Alimentary Tract.
Persistent Identifierhttp://hdl.handle.net/10722/88702
ISSN
2015 Impact Factor: 2.807
2015 SCImago Journal Rankings: 1.640
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChi, LLen_HK
dc.contributor.authorSheung, TFen_HK
dc.contributor.authorChung, MLen_HK
dc.contributor.authorSee, CCen_HK
dc.contributor.authorWai, KTen_HK
dc.contributor.authorNg, IOen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T09:46:51Z-
dc.date.available2010-09-06T09:46:51Z-
dc.date.issued2004en_HK
dc.identifier.citationJournal Of Gastrointestinal Surgery, 2004, v. 8 n. 7, p. 785-793en_HK
dc.identifier.issn1091-255Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/88702-
dc.description.abstractThe study goal was to review a single-center experience in hepatic resection for patients who presented with incidental liver tumors. With recent advances in diagnostic imaging techniques, incidental finding of liver tumors, or "incidentalomas," is increasing in asymptomatic and healthy individuals. However, little information is available in the literature regarding the underlying pathology and operative outcomes after hepatic resection. Between January 1989 and December 2002, 1011 patients underwent hepatic resection for liver tumors; of these patients, 107 (11%) were asymptomatic individuals who presented with incidentalomas. Incidentalomas were first detected on percutaneous ultrasonography (n = 83), computed tomography (n = 23), or magnetic resonance imaging (n = 1). Fifteen (14%) patients had preoperative aspiration for cytology or biopsy for histology, and the results correlated with the final pathology in 12 patients. Fifty-six (52%) patients underwent major hepatic resection with resection of three or more Coiunaud's segments. Median postoperative hospital stay was 8 days (range, 3-66 days). The operative mortality rate was 1%, and the operative morbidity rate was 21%. Histologic examination of the resected specimen revealed malignant liver tumors in 62 (58%) patients, including hepatocellular carcinoma (HCC) (n = 48), cholangiocarcinoma (n = 8), lymphoma (n = 2), cystadenocarcinoma (n = 2), carcinoid tumor (n = 1), and malignant fibrous histiocytoma (n = 1). Benign pathologies were found in 45 (42%) patients, including focal nodular hyperplasia (n = 17), hemangioma (n = 12), angiomyolipoma (n = 5), cirrhotic regenerative nodule (n = 4), hepatic adenoma (n = 2), and others (n = 5). On multivariate analysis, male sex, age of greater than 50 years, and tumor size of greater than 4 cm were the independent predictive factors for malignant diseases. On retrospective analysis, 48 patients with HCC who presented with incidentalomas had significantly better survival outcomes after hepatic resection than did 646 patients with HCC who presented otherwise during the same study period. Hepatic resection for patients with incidentalomas is associated with a low operative mortality and acceptable morbidity. The diagnosis of malignant disease, especially HCC, should be considered in male patients older than 50 years who present with large hepatic lesions. © 2004 The Society for Surgery of the Alimentary Tract.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC.en_HK
dc.relation.ispartofJournal of Gastrointestinal Surgeryen_HK
dc.subjectHepatic resectionen_HK
dc.subjectHepatocellular carcinomaen_HK
dc.subjectLiver tumorsen_HK
dc.subjectSurvival outcomesen_HK
dc.subject.meshCarcinoma, Hepatocellular - mortality - surgeryen_HK
dc.subject.meshCase-Control Studiesen_HK
dc.subject.meshCholangiocarcinoma - mortality - surgeryen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHemangioma - mortality - surgeryen_HK
dc.subject.meshHepatectomyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidental Findingsen_HK
dc.subject.meshLiver Diseases - mortality - surgeryen_HK
dc.subject.meshLiver Neoplasms - mortality - surgeryen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMultivariate Analysisen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSurvival Rateen_HK
dc.subject.meshTime Factorsen_HK
dc.titleHepatic resection for incidentalomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1091-255X&volume=8&issue=7&spage=785&epage=793&date=2004&atitle=Hepatic+resection+for+incidentalomaen_HK
dc.identifier.emailSee, CC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailNg, IO: iolng@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authoritySee, CC=rp01568en_HK
dc.identifier.authorityNg, IO=rp00335en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.gassur.2004.06.001en_HK
dc.identifier.pmid15531231-
dc.identifier.scopuseid_2-s2.0-16644402996en_HK
dc.identifier.hkuros96578en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-16644402996&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume8en_HK
dc.identifier.issue7en_HK
dc.identifier.spage785en_HK
dc.identifier.epage793en_HK
dc.identifier.isiWOS:000225633000006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChi, LL=7409789712en_HK
dc.identifier.scopusauthoridSheung, TF=6506234707en_HK
dc.identifier.scopusauthoridChung, ML=8696033300en_HK
dc.identifier.scopusauthoridSee, CC=7404255575en_HK
dc.identifier.scopusauthoridWai, KT=8696033500en_HK
dc.identifier.scopusauthoridNg, IO=7102753722en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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