Surgical Outcomes in Hepatitis C Virus-Related Hepatocellular Carcinoma: Special Reference to Sustained Virological Responses to Interferon Therapy

2017 ◽  
Vol 83 (11) ◽  
pp. 1246-1255 ◽  
Author(s):  
Shogo Tanaka ◽  
Akihiro Tamori ◽  
Shigekazu Takemura ◽  
Genya Hamano ◽  
Tokuji Ito ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Hepatic Resection ◽  
Surgical Outcomes ◽  
Interferon Therapy ◽  
Disease Free Survival ◽  
Control Group ◽  
Free Survival ◽  
Disease Free

Long-term surgical outcomes after hepatic resection for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) in patients who achieved a sustained virological response (SVR) to interferon (IFN) therapy remain inconclusive. Clinical records of 277 patients who underwent hepatic resection for HCV-related early stage HCC (met the Milan criteria) between 1993 and 2012 were retrospectively reviewed. Thirty-seven patients achieved the SVR during HCC detection (pre-SVR group), whereas 23 achieved SVR using adjuvant interferon therapy after hepatic resection (post-SVR group). The control group included remaining 217 patients. We investigated the SVR effects on surgical outcomes. Disease-free survival (DFS) rates at 5/10/15 years after hepatic resection were significantly greater in the pre and post-SVR groups than in the control group (46/30/30per cent and 61/36/27 per cent vs 23/7/7 per cent, respectively; P < 0.001). Overall survival (OS) rates at 10/15 years after hepatic resection were better in the pre- and post-SVR groups than in the control group (68/68 percent and 78/78 per cent vs 13/11 per cent, respectively; P < 0.001). On multivariate analysis, pre- and post-SVR were independent factors for no recurrence (pre-SVR: hazard ratio (HR), 0.48, P = 0.002; post-SVR: HR, 0.41, P = 0.001) and improved survival (pre-SVR: HR, 0.36, P = 0.002; post-SVR: HR, 0.122, P < 0.001). Achievement of SVR in patients with HCV-related HCC was associated with long-term disease-free survival and OS after hepatic resection.

Efficacy trend of hepatic resection for hepatocellular carcinoma with large multinodular tumor or macrovascular invasion.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 427-427 ◽  
Author(s):  
Jian-Hong Zhong ◽  
Le-Qun Li ◽  
Xin-Ping Ye ◽  
Yang Ke ◽  
Lin Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Liver Function ◽  
Hepatic Resection ◽  
Tertiary Care ◽  
Disease Free Survival ◽  
Recent Decade ◽  
Free Survival ◽  
Disease Free

427 Background: Official guidelines and retrospective studies have different view on the role of hepatic resection (HR) for patients with large (≥5 cm) multinodular (≥2) hepatocellular carcinoma (HCC) and those involving macrovascular invasion (MVI). We aim to evaluate the efficacy and its variation trend and the safety of HR for these patients in three tertiary care settings. Methods: A consecutive sample of 1,824 patients with Child-Pugh A liver function and large/multinodular HCC or involving MVI and who underwent initial HR were divided into four groups: large/multinodular HCC of the previous (2000-2004, n = 496) and recent five years (2005-2010, n = 765), involving MVI of the previous (n = 242) and recent five years (n = 321). Results: Among our patient sample, the hospital mortality was less than 5% and had a downward trend. Moreover, patients in recent five years have statistically significant longer survival time. Among patients with large/multinodular HCC, patients in recent five years showed a significantly better overall survival than those in previous five years at 1-year (92% vs. 84%), 3-year (69% vs. 61%), and 5-year (45% vs. 40%) (P = 0.004). Moreover, among patients involving MVI, overall survival in recent five years was significantly higher at 1-year (83% vs. 78%), 3-year (50% vs. 41%), and 5-year (25% vs. 17%) (P= 0.033). However, the disease-free survival of recent five years was only slightly higher than that of the previous five years in the two subgroups. Conclusions: HR offers good overall survival for patients with resectable large/multinodular HCC or those involving MVI and with preserved liver function. Outcomes have tended to improve in recent decade.

LONG-TERM RESULTS OF BRONCHOPLASTIC SURGICAL INTERVENTIONS IN COMPARISON WITH PNEUMONECTOMIES IN LUNG CANCER

2017 ◽  
Vol 63 (2) ◽  
pp. 234-239
Author(s):  
Yevgeniy Levchenko ◽  
Aleksandr Mikhnin ◽  
Stepan Yergnyan ◽  
Aleksey Barchuk ◽  
Leonid Gorokhov ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Rates ◽  
Group Versus ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Control Group ◽  
Free Survival ◽  
Surgical Interventions ◽  
Disease Free

The analysis of long-term results of surgical treatment of 198 patients with non-small cell lung cancer (NSCLC) I -III stages. Bronchoplasty (BP) interventions were performed in 99 cases, the control group comprised 99 patients after pneumonectomies (PE) corresponding to the main prognostic criteria for patients after BP interventions. A 1-year, 3-year and 5-year observed survival rates of patients were 87.7%, 56.2% and 44.6% after BP versus 82.8%, 54.6% and 35.9% after PE, respectively. A 1-year, 3-year and 5-year disease-free survival in the BP group was 87.9%, 64.2% and 52.3% versus 88.1%, 61.6% and 37.9% in the PE group. The median of overall and disease-free survival was 51.4 and 55.2 months in the BP group versus 46.2 and 41.0 months in the PE group, respectively.

Surgical technique and systemic inflammation influences long-term disease-free survival following hepatic resection for colorectal metastasis

2008 ◽  
Vol 98 (5) ◽  
pp. 371-376 ◽  
Author(s):  
Dhanwant Gomez ◽  
Gareth Morris-Stiff ◽  
Judy Wyatt ◽  
Giles J. Toogood ◽  
J. Peter A. Lodge ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Hepatic Resection ◽  
Systemic Inflammation ◽  
Disease Free Survival ◽  
Colorectal Metastasis ◽  
Free Survival ◽  
Disease Free

scholarly journals Potential Role of Adjuvant Lenvatinib in Improving Disease-Free Survival for Patients With High-Risk Hepatitis B Virus-Related Hepatocellular Carcinoma Following Liver Transplantation: A Retrospective, Case Control Study

2020 ◽  
Vol 10 ◽  
Author(s):  
Bing Han ◽  
Han Ding ◽  
Shuai Zhao ◽  
Yichi Zhang ◽  
Jian Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
High Risk ◽  
Disease Free Survival ◽  
Control Group ◽  
Free Survival ◽  
Risk Patients ◽  
Disease Free ◽  
Hcc Recurrence

Background and AimAlthough liver transplantation (LT) is one of the most effective treatments for the patients with hepatocellular carcinoma (HCC), the high-risk patients suffer from a high ratio of tumor recurrence after LT. Lenvatinib, as a novel targeted drug, has shown an excellent effect in the treatment of advanced HCC, but there is no study on its effect in preventing HCC recurrence in the patients undergoing transplantation. Therefore, this study was designed to evaluate the role of adjuvant lenvatinib in preventing recurrence of high-risk LT recipients with HBV-related HCC.MethodsWe retrospectively analyzed 23 high-risk patients consisting of lenvatinib group (n=14) and control group (n=9) with HBV-related HCC who underwent LT in our center. Disease-free survival (DFS) and HCC recurrence of the two groups were compared. The adverse events (AEs) and drug tolerance of lenvatinib were evaluated.ResultsThe median DFS in lenvatinib group was 291 (95%CI 204–516) days, significantly longer than 182 (95%CI 56–537) days in control group (P=0.04). Three patients in lenvatinib group (21.4%) and five patients in control group (55.6%) had short-term HCC recurrence (P=0.11). All patients in lenvatinib group could tolerate oral lenvatinib for at least three cycles except six cases (42.9%) of dose reduction and 1 case of interruption (14.3%). Thirteen patients (92.9%) taking lenvatinib experienced AEs. The most common AEs were hypertension (64.3%) and proteinuria (42.9%), and the most serious AEs were Grade 3 for 4 cases (28.5%) according to common terminology criteria for adverse events (CTCAE) version 5.0. Additionally, no influence of lenvatinib on the dosage and blood concentration of FK506 was observed.ConclusionsAdjuvant lenvatinib had a potential benefit on prolonging the DFS and reducing the recurrence of high-risk HBV-related HCC patients following liver transplantation with an acceptable drug safety and patient tolerance.

Evolving Role of Hepatic Resection for Metastatic Urologic Malignancies

2017 ◽  
Vol 83 (6) ◽  
pp. 628-632 ◽  
Author(s):  
John B. Hamner ◽  
Mustafa Raoof ◽  
Sinziana Dumitra ◽  
Hans F. Schoellhammer ◽  
Carly Crowder ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Resection ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
R0 Resection ◽  
Term Survival ◽  
Free Survival ◽  
Urologic Malignancies ◽  
Disease Free

Liver resection for noncolorectal, nonneuroendocrine metastases remains controversial. Here, we evaluate a single institutional experience with hepatic resection for metastatic urologic malignancies. A single-institution review of patients who underwent hepatic resection for metastatic urologic tumors between the years of 2000 and 2013 was performed. Patient charts were analyzed for pathologic data and perioperative outcomes including short- and long-term morbidity, mortality, and overall and disease-free survival. Eleven patients were identified who underwent hepatic resection for metastatic urologic malignancy. The mean age was 63.5 years. All patients had an R0 resection. There were three major complications. Mean length of stay was 6.5 days and there was no 90-day mortality. Three patients have died of recurrent disease at an average of 11.2 months from resection to death. The remaining patients are still alive during a mean follow-up of 31.5 months. Five-year overall and disease-free survival was 50 and 21 months, respectively. Hepatic resection for metastatic urologic tumors is safe with low morbidity and mortality and durable long-term survival can be achieved. Liver resection for isolated hepatic disease should be considered for this rare metastatic disease to the liver.

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