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- Publisher Website: 10.1007/s00268-014-2601-4
- Scopus: eid_2-s2.0-84905678614
- PMID: 24831671
- WOS: WOS:000340421700029
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Article: Treatment strategy to improve long-term survival for hepatocellular carcinoma smaller than 5 cm: Major hepatectomy vs minor hepatectomy
Title | Treatment strategy to improve long-term survival for hepatocellular carcinoma smaller than 5 cm: Major hepatectomy vs minor hepatectomy |
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Authors | |
Issue Date | 2014 |
Citation | World Journal of Surgery, 2014, v. 38, n. 9, p. 2386-2394 How to Cite? |
Abstract | Background: The extent of hepatectomy for solitary hepatocellular carcinoma (HCC) <5 cm is controversial. Methods: This is a retrospective review of patients with solitary HCC <5 cm, who underwent liver resection in a tertiary referral centre in Hong Kong between January 1989 and December 2009. Baseline demographics, liver function, peri-operative outcomes, and overall survival were compared. Results: A total of 348 cirrhotic patients with a solitary HCC <5 cm underwent either major hepatectomy (n = 93) or minor hepatectomy (n = 255). Child-Pugh status did not differ, 98.9 vs. 96.1 % (p = 0.319); all patients who underwent major and minor hepatectomy were classified as Child-Pugh status A. Patients who underwent major hepatectomy had a larger median tumor size (4.0 vs. 2.5 cm, p < 0.001) and they also had more advanced stage of disease (stage I/II/IIIa: 10.8/55.9/33.3 vs. 26.7/52.9/20.4 %, p = 0.002). Median operative time for major hepatectomy was significantly longer (415 vs. 248 min, p < 0.001) and entailed greater blood loss (0.9 vs. 0.5 l, p < 0.001). Despite larger tumor size and more advanced stage of disease in the major hepatectomy group, hospital mortality (5.4 vs. 2.0 %, p = 0.185), complication rates (30.1 vs. 23.1 %, p = 0.234), and transfusion rate (10.8 vs. 11.4 %, p = 0.862) were the same between the two groups. Overall survival was significantly better for those who underwent major hepatectomy, with a median survival of 147.5 vs. 92.1 months (p = 0.043), and they had a better 5- and 10-year disease-free survival rate (57.3 vs. 40.2, 38.1 vs. 18.9 %, p = 0.003). In subgroup analysis, the 10-year survival for patients with stage II HCC and tumor <5 cm was 68.6 vs. 36.6 % in those who received minor hepatectomy alone (p = 0.027). Conclusions: Major hepatectomy provided better long-term survival benefit in patients with HCC <5 cm, particularly in those with stage II disease. © 2014 Société Internationale de Chirurgie. |
Persistent Identifier | http://hdl.handle.net/10722/221371 |
ISSN | 2023 Impact Factor: 2.3 2023 SCImago Journal Rankings: 0.772 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wong, TCL | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Chok, KSH | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Dai, WC | - |
dc.contributor.author | Chan, SC | - |
dc.contributor.author | Poon, RTP | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2015-11-18T06:09:08Z | - |
dc.date.available | 2015-11-18T06:09:08Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | World Journal of Surgery, 2014, v. 38, n. 9, p. 2386-2394 | - |
dc.identifier.issn | 0364-2313 | - |
dc.identifier.uri | http://hdl.handle.net/10722/221371 | - |
dc.description.abstract | Background: The extent of hepatectomy for solitary hepatocellular carcinoma (HCC) <5 cm is controversial. Methods: This is a retrospective review of patients with solitary HCC <5 cm, who underwent liver resection in a tertiary referral centre in Hong Kong between January 1989 and December 2009. Baseline demographics, liver function, peri-operative outcomes, and overall survival were compared. Results: A total of 348 cirrhotic patients with a solitary HCC <5 cm underwent either major hepatectomy (n = 93) or minor hepatectomy (n = 255). Child-Pugh status did not differ, 98.9 vs. 96.1 % (p = 0.319); all patients who underwent major and minor hepatectomy were classified as Child-Pugh status A. Patients who underwent major hepatectomy had a larger median tumor size (4.0 vs. 2.5 cm, p < 0.001) and they also had more advanced stage of disease (stage I/II/IIIa: 10.8/55.9/33.3 vs. 26.7/52.9/20.4 %, p = 0.002). Median operative time for major hepatectomy was significantly longer (415 vs. 248 min, p < 0.001) and entailed greater blood loss (0.9 vs. 0.5 l, p < 0.001). Despite larger tumor size and more advanced stage of disease in the major hepatectomy group, hospital mortality (5.4 vs. 2.0 %, p = 0.185), complication rates (30.1 vs. 23.1 %, p = 0.234), and transfusion rate (10.8 vs. 11.4 %, p = 0.862) were the same between the two groups. Overall survival was significantly better for those who underwent major hepatectomy, with a median survival of 147.5 vs. 92.1 months (p = 0.043), and they had a better 5- and 10-year disease-free survival rate (57.3 vs. 40.2, 38.1 vs. 18.9 %, p = 0.003). In subgroup analysis, the 10-year survival for patients with stage II HCC and tumor <5 cm was 68.6 vs. 36.6 % in those who received minor hepatectomy alone (p = 0.027). Conclusions: Major hepatectomy provided better long-term survival benefit in patients with HCC <5 cm, particularly in those with stage II disease. © 2014 Société Internationale de Chirurgie. | - |
dc.language | eng | - |
dc.relation.ispartof | World Journal of Surgery | - |
dc.title | Treatment strategy to improve long-term survival for hepatocellular carcinoma smaller than 5 cm: Major hepatectomy vs minor hepatectomy | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1007/s00268-014-2601-4 | - |
dc.identifier.pmid | 24831671 | - |
dc.identifier.scopus | eid_2-s2.0-84905678614 | - |
dc.identifier.hkuros | 233271 | - |
dc.identifier.volume | 38 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 2386 | - |
dc.identifier.epage | 2394 | - |
dc.identifier.eissn | 1432-2323 | - |
dc.identifier.isi | WOS:000340421700029 | - |
dc.identifier.issnl | 0364-2313 | - |