Proposal of a Nomogram to Predict Surgical Risks and Survival Benefit after Liver Resection for Hepatocellular Carcinoma on Child-Pugh Class B Liver Cirrhosis: Short- and Long-Term Outcomes from an International Multi-Institutional Analysis

2019 ◽  
Vol 229 (4) ◽  
pp. S183
Author(s):  
Giammauro Berardi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Liver Resection ◽  
Survival Benefit ◽  
Institutional Analysis ◽  
Long Term Outcomes ◽  
Class B ◽  
Pugh Class ◽  
Short And Long Term

scholarly journals Effect of Severity of Liver Cirrhosis on Surgical Outcomes of Hepatocellular Carcinoma After Liver Resection and Microwave Coagulation

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiang Li ◽  
Hai-su Tao ◽  
Jian Li ◽  
Wen-qiang Wang ◽  
Wei-wei Sheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Liver Resection ◽  
Liver Function ◽  
Subgroup Analysis ◽  
Surgical Outcomes ◽  
Long Term Outcomes ◽  
Microwave Coagulation ◽  
Small Hcc

BackgroundLiver resection (LR) and percutaneous microwave coagulation therapy (PMCT) are both considered as radical treatments for small hepatocellular carcinoma (HCC). However, it is still unclear whether to select LR or PMCT in HCC patients with different degrees of liver cirrhosis. The purpose of this study was to compare the efficacy of LR and PMCT in the treatment of solitary and small HCC accompanied with different degrees of liver cirrhosis.MethodsIn this study, 230 patients with solitary HCC lesions ≤ 3 cm and Child-Pugh A liver function were retrospectively reviewed. Among these patients, 122 patients underwent LR, and 108 received PMCT. The short- and long-term outcomes were compared between these two procedures. Severity of liver cirrhosis was evaluated by using clinical scoring system (CSS) as previously published. Subgroup analysis based on CSS was performed to evaluate the effect of severity of liver cirrhosis on surgical outcomes after LR and PMCT.ResultsThere was no mortality within 90 days in both groups. Major complications were significantly more frequent in the LR group than in the PMCT group (18.8% vs. 4.6%, p<0.001). However, LR provided better surgical outcomes than PMCT. The 5-year overall survival (OS) rates for the LR and PMCT groups were 65.2% and 42%, respectively (p=0.006), and the corresponding disease-free survival (DFS) rates were 51.7% and 31.5%, respectively (p=0.004). Nevertheless, subgroup analysis showed that PMCT provided long-term outcomes that were similar to LR and lower surgical complications in HCC patients with CSS score≥4.ConclusionsLR may provide better OS and DFS rates than PMCT for patients with solitary HCC lesions ≤ 3 cm and Child-Pugh A liver function irrespective of liver cirrhosis. PMCT should be viewed as the optimal treatment for solitary and small HCC with severe cirrhosis.

scholarly journals Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 964-972
Author(s):  
Aoxiao He ◽  
Zhihao Huang ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Rongguiyi Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Major Hepatectomy ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Laparoscopic Major Hepatectomy

Abstract Background The feasibility and safety of laparoscopic major hepatectomy (LMH) are still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC). Method Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes, and long-term oncologic outcomes were reviewed. Results Intraoperative blood loss (P = 0.007) was significantly lower in the LMH group. In addition, the LMH group exhibited a lower overall complication rate (P = 0.039) and shorter postoperative hospital stay (P = 0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P = 0.215) and operative cost (P = 0.860). Two laparoscopic cases were converted to open liver resection. In regard to long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P = 0.079) and overall survival (OS) (P = 0.172). Conclusion LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.

scholarly journals Preoperative prognostic nutritional index predicts both short and long-term outcomes after liver resection for hepatocellular carcinoma.

2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Nutritional Index ◽  
Short And Long Term ◽  
Disease Free

Abstract Background The aim of this study was to investigate the prognostic significance of the prognostic nutritional index (PNI) for both short and long term outcomes after liver resection for hepatocellular carcinoma (HCC). Methods 162 (without any previous treatment) of 229 surgically treated HCC patients were retrospectively analyzed. The cut off value of the preoperative PNI was 45.0. Patients were divided into two groups, PNI low (n=76) and high (n=86) group. Results Among some immune parameters such as PNI, neutrophil to lymphocyte ratio (NLR) and aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), PNI had most reliable parameters in terms with prediction of both short and long term outcomes. Preoperative PNI tended to correlate with low skeletal muscle mass (SMM). In short term outcomes, PNI low group were more likely to have postoperative complications. The disease-free survival rate in PNI low group was significantly worse than that in the PNI high group (20.5 vs. 48.7 %, 5 year SR, p=0.03). On multivariate analysis, Low PNI was an independent prognostic factor for disease free survival (HR 1.65, p= 0.04). Conclusions The preoperative PNI was the most significant prognostic factor for evaluating both short and long-term outcomes after liver resection for HCC.

scholarly journals Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

2020 ◽  
Author(s):  
Aoxiao He ◽  
Yong Li ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Wenjun Liao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Major Hepatectomy ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Laparoscopic Major Hepatectomy

Abstract Background: The feasibility and safety of laparoscopic major hepatectomy (LMH) is still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC).Method: Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes and long-term oncologic outcomes were reviewed.Results: Intraoperative blood loss (P=0.007) were significantly lower in LMH group. In addition, LMH group exhibited a lower overall complication rate (P=0.039) and shorter postoperative hospital stay (P=0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P=0.215) and overall cost (P=0.024). Two laparoscopic cases were converted to open liver resection. In regard with long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P=0.079) and overall survival (OS) (P=0.172).Conclusion: LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.

scholarly journals Preoperative prognostic nutritional index predicts both short and long-term outcomes after liver resection for hepatocellular carcinoma.

2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Nutritional Index ◽  
Short And Long Term ◽  
Disease Free

Abstract Background The aim of this study was to investigate the prognostic significance of the prognostic nutritional index (PNI) for both short and long term outcomes after liver resection for hepatocellular carcinoma (HCC). Methods 162 (without any previous treatment) of 229 surgically treated HCC patients were retrospectively analyzed. The cut off value of the preoperative PNI was 45.0. Patients were divided into two groups, PNI low (n=76) and high (n=86) group. Results Among some immune parameters such as PNI, neutrophil to lymphocyte ratio (NLR) and aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), PNI had most reliable parameters in terms with prediction of both short and long term outcomes. Preoperative PNI tended to correlate with low skeletal muscle mass (SMM). In short term outcomes, PNI low group were more likely to have postoperative complications. The disease-free survival rate in PNI low group was significantly worse than that in the PNI high group (20.5 vs. 48.7 %, 5 year SR, p=0.03). On multivariate analysis, Low PNI was an independent prognostic factor for disease free survival (HR 1.65, p= 0.04). Conclusions The preoperative PNI was the most significant prognostic factor for evaluating both short and long-term outcomes after liver resection for HCC.

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