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Article: Aggressive management of patients with extrahepatic and intrahepatic recurrences of hepatocellular carcinoma by combined resection and locoregional therapy

TitleAggressive management of patients with extrahepatic and intrahepatic recurrences of hepatocellular carcinoma by combined resection and locoregional therapy
Authors
Issue Date2002
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jamcollsurg
Citation
Journal Of The American College Of Surgeons, 2002, v. 195 n. 3, p. 311-318 How to Cite?
AbstractBACKGROUND: Resection of hepatocellular carcinoma (HCC) is associated with a high incidence of recurrence. Aggressive management of recurrence is an important strategy in prolonging survival. This study evaluated the role of combined resection and locoregional therapy in the management of selected patients with extrahepatic and intrahepatic recurrences. STUDY DESIGN: From a prospective database of 399 patients with hepatectomy for HCC from 1989 to 1998, 63 patients were identified with extrahepatic and intrahepatic recurrences either concurrently or sequentially. Survival outcomes of patients who underwent resection of extrahepatic recurrence and re-resection or locoregional therapy for intrahepatic recurrence were evaluated. RESULTS: Ten patients underwent resection of solitary extrahepatic recurrence and locoregional therapy for intrahepatic recurrence. Transarterial chemoembolization was the main treatment modality for intrahepatic recurrence. Two of these patients also underwent re-resection of intrahepatic recurrence at the time of resection of extrahepatic metastasis. Median survival after recurrence of these 10 patients was 44.0 months (range 18.6 to 132.9 months), and the median overall survival from initial hepatectomy was 49.0 months (range 21.6 to 134.6 months). In contrast, median survival after recurrence of the remaining 53 patients with extrahepatic and intrahepatic recurrences treated by nonsurgical means (locoregional therapy, systemic chemotherapy, or hormonal therapy) was only 10.6 months (p = 0.002). CONCLUSIONS: Aggressive management with combined resection of isolated extrahepatic recurrence and reresection or locoregional therapy for intrahepatic recurrence may offer longterm survival in selected patients who develop both intrahepatic and extrahepatic recurrences after hepatectomy for HCC. © 2002 by the American College of Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/84487
ISSN
2023 Impact Factor: 3.8
2023 SCImago Journal Rankings: 1.419
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorO'Suilleabhain, CBen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:53:32Z-
dc.date.available2010-09-06T08:53:32Z-
dc.date.issued2002en_HK
dc.identifier.citationJournal Of The American College Of Surgeons, 2002, v. 195 n. 3, p. 311-318en_HK
dc.identifier.issn1072-7515en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84487-
dc.description.abstractBACKGROUND: Resection of hepatocellular carcinoma (HCC) is associated with a high incidence of recurrence. Aggressive management of recurrence is an important strategy in prolonging survival. This study evaluated the role of combined resection and locoregional therapy in the management of selected patients with extrahepatic and intrahepatic recurrences. STUDY DESIGN: From a prospective database of 399 patients with hepatectomy for HCC from 1989 to 1998, 63 patients were identified with extrahepatic and intrahepatic recurrences either concurrently or sequentially. Survival outcomes of patients who underwent resection of extrahepatic recurrence and re-resection or locoregional therapy for intrahepatic recurrence were evaluated. RESULTS: Ten patients underwent resection of solitary extrahepatic recurrence and locoregional therapy for intrahepatic recurrence. Transarterial chemoembolization was the main treatment modality for intrahepatic recurrence. Two of these patients also underwent re-resection of intrahepatic recurrence at the time of resection of extrahepatic metastasis. Median survival after recurrence of these 10 patients was 44.0 months (range 18.6 to 132.9 months), and the median overall survival from initial hepatectomy was 49.0 months (range 21.6 to 134.6 months). In contrast, median survival after recurrence of the remaining 53 patients with extrahepatic and intrahepatic recurrences treated by nonsurgical means (locoregional therapy, systemic chemotherapy, or hormonal therapy) was only 10.6 months (p = 0.002). CONCLUSIONS: Aggressive management with combined resection of isolated extrahepatic recurrence and reresection or locoregional therapy for intrahepatic recurrence may offer longterm survival in selected patients who develop both intrahepatic and extrahepatic recurrences after hepatectomy for HCC. © 2002 by the American College of Surgeons.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jamcollsurgen_HK
dc.relation.ispartofJournal of the American College of Surgeonsen_HK
dc.rightsJournal of American College of Surgeons. Copyright © Elsevier Inc.en_HK
dc.titleAggressive management of patients with extrahepatic and intrahepatic recurrences of hepatocellular carcinoma by combined resection and locoregional therapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1072-7515&volume=195&spage=311&epage=318&date=2002&atitle=Aggressive+management+of+patients+with+extrahepatic+and+intrahepatic+recurrences+of+hepatocellular+carcinoma+by+combined+resection+and+locoregional+therapyen_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S1072-7515(02)01226-7en_HK
dc.identifier.pmid12229937-
dc.identifier.scopuseid_2-s2.0-0036712609en_HK
dc.identifier.hkuros77803en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036712609&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume195en_HK
dc.identifier.issue3en_HK
dc.identifier.spage311en_HK
dc.identifier.epage318en_HK
dc.identifier.isiWOS:000177875700002-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridO'Suilleabhain, CB=6603409696en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK
dc.identifier.issnl1072-7515-

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