Appropriate liver resection type for patients with the American joint committee on cancer classification T1 and T2 hepatocellular carcinoma

Chung-Bao Hsieh, Kuo-Piao Chung, Chi-Ming Chu, Jyh-Cherng Yu, Huan-Fa Hsieh, Heng-Cheng Chu, Chih-Yung Yu, Teng-Wei Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Synopsis: Major liver resection prevents intrahepatic tumor recurrence in T2 hepatocellular carcinoma patients with microvascular invasion or daughter nodules. Background and Objectives: There is no consensus on whether major or minor hepatectomy is better for hepatocellular carcinoma (HCC) patients. We investigated the outcomes of liver resection type in resectable HCC patients. Methods: Two hundred sixty-three HCC patients with Child-Pugh class A liver function who underwent curative hepatectomy were enrolled. Among them, 186 patients had pathologic stage T1 HCC and 77 had stage T2 HCC. Patients were also classed according to the type of resection (major or minor). Clinicopathologic characteristics and outcomes were compared. Results: Patients with T1 HCC who underwent major resection had a higher rate of blood transfusion than those who underwent minor resection (P <0.001). The disease-free survival rate of T2 patients who underwent major resection was better than that of patients who underwent minor resection (P = 0.004). The overall survival rates of T1 and T2 HCC patients did not differ significantly between those with major or minor resection. Conclusions: Major liver resection is recommended for T2 HCC patients with adequate remnant liver function because it results in a better disease-free survival rate than does minor resection in these patients. Minor liver resection is suggested for T1 HCC patients, except for those with a tumor sitting close to vessels, because it is associated with a low incidence of blood transfusion and a good survival rate. © 2010 Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)497-504
Number of pages8
JournalEuropean Journal of Surgical Oncology
Volume37
Issue number6
DOIs
Publication statusPublished - 2011
Externally publishedYes

Fingerprint

Hepatocellular Carcinoma
Liver
Neoplasms
Survival Rate
Hepatectomy
Blood Transfusion
Disease-Free Survival
Recurrence
Incidence

Keywords

  • Hepatectomy
  • Hepatocellular carcinoma
  • Surgical strategy
  • Survival
  • adult
  • aged
  • article
  • blood transfusion
  • cancer classification
  • cancer invasion
  • disease free survival
  • female
  • hemihepatectomy
  • human
  • liver cell carcinoma
  • liver function
  • liver resection
  • major clinical study
  • male
  • morbidity
  • overall survival
  • priority journal
  • prognosis
  • surgical mortality
  • treatment outcome
  • tumor recurrence
  • Adult
  • Aged
  • Aged, 80 and over
  • alpha-Fetoproteins
  • Carcinoma, Hepatocellular
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • Survival Analysis
  • Tumor Markers, Biological

Cite this

Appropriate liver resection type for patients with the American joint committee on cancer classification T1 and T2 hepatocellular carcinoma. / Hsieh, Chung-Bao; Chung, Kuo-Piao; Chu, Chi-Ming; Yu, Jyh-Cherng; Hsieh, Huan-Fa; Chu, Heng-Cheng; Yu, Chih-Yung; Chen, Teng-Wei.

In: European Journal of Surgical Oncology, Vol. 37, No. 6, 2011, p. 497-504.

Research output: Contribution to journalArticle

Hsieh, Chung-Bao ; Chung, Kuo-Piao ; Chu, Chi-Ming ; Yu, Jyh-Cherng ; Hsieh, Huan-Fa ; Chu, Heng-Cheng ; Yu, Chih-Yung ; Chen, Teng-Wei. / Appropriate liver resection type for patients with the American joint committee on cancer classification T1 and T2 hepatocellular carcinoma. In: European Journal of Surgical Oncology. 2011 ; Vol. 37, No. 6. pp. 497-504.
@article{3402894da10147028657f649d87b4482,
title = "Appropriate liver resection type for patients with the American joint committee on cancer classification T1 and T2 hepatocellular carcinoma",
abstract = "Synopsis: Major liver resection prevents intrahepatic tumor recurrence in T2 hepatocellular carcinoma patients with microvascular invasion or daughter nodules. Background and Objectives: There is no consensus on whether major or minor hepatectomy is better for hepatocellular carcinoma (HCC) patients. We investigated the outcomes of liver resection type in resectable HCC patients. Methods: Two hundred sixty-three HCC patients with Child-Pugh class A liver function who underwent curative hepatectomy were enrolled. Among them, 186 patients had pathologic stage T1 HCC and 77 had stage T2 HCC. Patients were also classed according to the type of resection (major or minor). Clinicopathologic characteristics and outcomes were compared. Results: Patients with T1 HCC who underwent major resection had a higher rate of blood transfusion than those who underwent minor resection (P <0.001). The disease-free survival rate of T2 patients who underwent major resection was better than that of patients who underwent minor resection (P = 0.004). The overall survival rates of T1 and T2 HCC patients did not differ significantly between those with major or minor resection. Conclusions: Major liver resection is recommended for T2 HCC patients with adequate remnant liver function because it results in a better disease-free survival rate than does minor resection in these patients. Minor liver resection is suggested for T1 HCC patients, except for those with a tumor sitting close to vessels, because it is associated with a low incidence of blood transfusion and a good survival rate. {\circledC} 2010 Elsevier Ltd. All rights reserved.",
keywords = "Hepatectomy, Hepatocellular carcinoma, Surgical strategy, Survival, adult, aged, article, blood transfusion, cancer classification, cancer invasion, disease free survival, female, hemihepatectomy, human, liver cell carcinoma, liver function, liver resection, major clinical study, male, morbidity, overall survival, priority journal, prognosis, surgical mortality, treatment outcome, tumor recurrence, Adult, Aged, Aged, 80 and over, alpha-Fetoproteins, Carcinoma, Hepatocellular, Disease-Free Survival, Female, Follow-Up Studies, Humans, Liver Neoplasms, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Proportional Hazards Models, Risk Factors, Survival Analysis, Tumor Markers, Biological",
author = "Chung-Bao Hsieh and Kuo-Piao Chung and Chi-Ming Chu and Jyh-Cherng Yu and Huan-Fa Hsieh and Heng-Cheng Chu and Chih-Yung Yu and Teng-Wei Chen",
note = "被引用次數:1 Export Date: 22 March 2016 CODEN: EJSOE 通訊地址: Chen, T. W.; Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Cheng-Kung Road, Taipei 114, Taiwan; 電子郵件: tengweichen@yahoo.com.tw 化學物質/CAS: Tumor Markers, Biological; alpha-Fetoproteins 參考文獻: Fattovich, G., Stroffolini, T., Zagni, I., Hepatocellular carcinoma in cirrhosis: Incidence and risk factors (2004) Gastroenterology, 127, pp. 35-50; Mullin, E.J., Metcalfe, M.S., Maddern, G.J., How much liver resection is too much? (2005) American Journal of Surgery, 190 (1), pp. 87-97. , DOI 10.1016/j.amjsurg.2005.01.043, PII S0002961005003442; Chau, G.Y., Lui, W.Y., Tsay, S.H., Prognostic significance of surgical margin in hepatocellular carcinoma resection: An analysis of 165 Child's A patients (1997) J Surg Oncol, 66, pp. 122-126; Shi, M., Guo, R.-P., Lin, X.-J., Zhang, Y.-Q., Chen, M.-S., Zhang, C.-Q., Lau, W.Y., Li, J.-Q., Partial hepatectomy with wide versus narrow resection margin for solitary hepatocellular carcinoma: A prospective randomized trial (2007) Annals of Surgery, 245 (1), pp. 36-43. , DOI 10.1097/01.sla.0000231758.07868.71, PII 0000065820070100000007; Hasegawa, K., Kokudo, N., Imamura, H., Matsuyama, Y., Aoki, T., Minagawa, M., Sano, K., Makuuchi, M., Prognostic impact of anatomic resection for hepatocellular carcinoma (2005) Annals of Surgery, 242 (2), pp. 252-259. , DOI 10.1097/01.sla.0000171307.37401.db; Wakai, T., Shirai, Y., Sakata, J., Kaneko, K., Cruz, P.V., Akazawa, K., Hatakeyama, K., Anatomic resection independently improves long-term survival in patients with T1-T2 hepatocellular carcinoma (2007) Annals of Surgical Oncology, 14 (4), pp. 1356-1365. , DOI 10.1245/s10434-006-9318-z; Tanaka, K., Shimada, H., Matsumoto, C., Matsuo, K., Nagano, Y., Endo, I., Togo, S., Anatomic versus limited nonanatomic resection for solitary hepatocellular carcinoma (2008) Surgery, 143 (5), pp. 607-615. , DOI 10.1016/j.surg.2008.01.006, PII S0039606008001177; Greene, F.L., Page, D.L., Fleming, I.D., (2002) AJCC Cancer Staging Manual, , 6th ed. Springer-Verlag New York; The Brisbane 2000 terminology of liver anatomy and resections (2000) HPB, 2, pp. 333-339. , Terminology Committee of the International Hepato-Pancreato-Biliary Association; Makuuchi, M., Hasegawa, H., Yamazaki, S., Ultrasonically guided subsegmentectomy (1985) Surgery Gynecology and Obstetrics, 161 (4), pp. 346-350; Chen, T.W., Chu, C.M., Yu, J.C., Chen, C.J., Chan, D.C., Liu, Y.C., Hsieh, C.B., Comparison of clinical staging systems in predicting survival of hepatocellular carcinoma patients receiving major or minor hepatectomy (2007) European Journal of Surgical Oncology, 33 (4), pp. 480-487. , DOI 10.1016/j.ejso.2006.10.012, PII S0748798306003970; Poon, R.T.-P., Fan, S.-T., Ng, I.O.-L., Wong, J., Significance of resection margin in hepatectomy for hepatocellular carcinoma: A critical reappraisal (2000) Annals of Surgery, 231 (4), pp. 544-551. , DOI 10.1097/00000658-200004000-00014; Ariizumi, S.-I., Yamamoto, M., Ohtsubo, T., Katsuragawa, H., Katagiri, S., Takasaki, K., Step classification is useful for the determination of indications for systematized hepatectomy in hepatocellular carcinoma (2005) Journal of Hepato-Biliary-Pancreatic Surgery, 12 (5), pp. 371-377. , DOI 10.1007/s00534-005-1003-2; Ariizumi, S.-I., Katagiri, S., Katsuragawa, H., Kotera, Y., Yamamoto, M., Sectionectomy is suitable for patients with T2 hepatocellular carcinoma according to the modified international union against cancer TNM classification (2007) Digestive Surgery, 24 (5), pp. 342-348. , DOI 10.1159/000107714; Ochiai, T., Sonoyama, T., Kikuchi, S., Okayama, T., Konishi, H., Kitagawa, M., Tagi, T., Otsuji, E., Anatomic wide hepatectomy for treatment of hepatocellular carcinoma (2007) Journal of Cancer Research and Clinical Oncology, 133 (8), pp. 563-569. , DOI 10.1007/s00432-007-0205-1; Chen, M.F., Hwang, T.L., Jeng, L.B., Postoperative recurrence of hepatocellular carcinoma. Two hundred five consecutive patients who underwent hepatic resection in 15 years (1994) Arch Surg, 129, pp. 738-742; Eguchi, S., Kanematsu, T., Arii, S., Okazaki, M., Okita, K., Omata, M., Ikai, I., Takayasu, K., Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey (2008) Surgery, 143 (4), pp. 469-475. , DOI 10.1016/j.surg.2007.12.003, PII S0039606008000822; Hsieh, C.B., Yu, C.Y., Tzao, C., Chu, H.C., Chen, T.W., Hsieh, H.F., Liu, Y.C., Yu, J.C., Prediction of the risk of hepatic failure in patients with portal vein invasion hepatoma after hepatic resection (2006) European Journal of Surgical Oncology, 32 (1), pp. 72-76. , DOI 10.1016/j.ejso.2005.09.003, PII S0748798305002386; Imamura, H., Sano, K., Sugawara, Y., Kokudo, N., Makuuchi, M., Assessment of hepatic reserve for indication of hepatic resection: Decision tree incorporating indocyanine green test (2005) Journal of Hepato-Biliary-Pancreatic Surgery, 12 (1), pp. 16-22. , DOI 10.1007/s00534-004-0965-9; Cho, Y.B., Lee, K.U., Lee, H.W., Cho, E.-H., Yang, S.-H., Cho, J.Y., Yi, N.-J., Suh, K.-S., Outcomes of hepatic resection for a single large hepatocellular carcinoma (2007) World Journal of Surgery, 31 (4), pp. 795-801. , DOI 10.1007/s00268-006-0359-z; Wakai, T., Shirai, Y., Yokoyama, N., Nagakura, S., Hatakeyama, K., Hepatitis viral status affects the pattern of intrahepatic recurrence after resection for hepatocellular carcinoma (2003) European Journal of Surgical Oncology, 29 (3), pp. 266-271. , DOI 10.1053/ejso.2002.1395; Sakon, M., Umeshita, K., Nagano, H., Clinical significance of hepatic resection in hepatocellular carcinoma: Analysis by disease-free survival curves (2000) Arch Surg, 135, pp. 1546-1549; Imamura, H., Matsuyama, Y., Tanaka, E., Ohkubo, T., Hasegawa, K., Miyagawa, S., Sugawara, Y., Makuuchi, M., Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy (2003) Journal of Hepatology, 38 (2), pp. 200-207. , DOI 10.1016/S0168-8278(02)00360-4; Yanaga, K., Kanematsu, T., Takenaka, K., Matsumata, T., Yoshida, Y., Sugimachi, K., Hepatic resection for hepatocellular carcinoma in elderly patients (1988) American Journal of Surgery, 155 (2), pp. 238-241; Nagasue, N., Chang, Y.-C., Takemoto, Y., Taniura, H., Kohno, H., Nakamura, T., Liver resection in the aged (seventy years or older) with hepatocellular carcinoma (1993) Surgery, 113 (2), pp. 148-154; Huang, J., Li, B.K., Chen, G.H., Long-term outcome and prognostic factors of elderly patients with hepatocellular carcinoma undergoing hepatectomy (2009) J Gastrointest Surg, 13, pp. 1627-1635; Ng, I.O.L., Ng, M.M.T., Lai, E.C.S., Better survival in female patients with hepatocellular carcinoma. Possible causes from a pathologic approach (1995) Cancer, 75, pp. 18-22; Kubo, S., Hirohashi, K., Tanaka, H., Tsukamoto, T., Shuto, T., Yamamoto, T., Ikebe, T., Kinoshita, H., Effect of viral status on recurrence after liver resection for patients with hepatitis B virus-related hepatocellular carcinoma (2000) Cancer, 88 (5), pp. 1016-1024. , DOI 10.1002/(SICI)1097-0142(20000301)88:5<1016::AID-CNCR10>3.0. CO;2-V; Eguchi, S., Ijtsma, A.J.C., Slooff, M.J.H., Porte, R.J., De Jong, K.P., Peeters, P.M.J.G., Gouw, A.S.H., Kanematsu, T., Outcome and pattern of recurrence after curative resection for hepatocellular carcinoma in patients with a normal liver compared to patients with a diseased liver (2006) Hepato-Gastroenterology, 53 (70), pp. 592-596; Yano, M., Hamatani, K., Eguchi, H., Hirai, Y., MacPhee, D.G., Sugino, K., Dohi, K., Asahara, T., Prognosis in patients with hepatocellular carcinoma correlates to mutations of p53 and/or hMSH2 genes (2007) European Journal of Cancer, 43 (6), pp. 1092-1100. , DOI 10.1016/j.ejca.2007.01.032, PII S0959804907001207",
year = "2011",
doi = "10.1016/j.ejso.2011.03.004",
language = "English",
volume = "37",
pages = "497--504",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Appropriate liver resection type for patients with the American joint committee on cancer classification T1 and T2 hepatocellular carcinoma

AU - Hsieh, Chung-Bao

AU - Chung, Kuo-Piao

AU - Chu, Chi-Ming

AU - Yu, Jyh-Cherng

AU - Hsieh, Huan-Fa

AU - Chu, Heng-Cheng

AU - Yu, Chih-Yung

AU - Chen, Teng-Wei

N1 - 被引用次數:1 Export Date: 22 March 2016 CODEN: EJSOE 通訊地址: Chen, T. W.; Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Cheng-Kung Road, Taipei 114, Taiwan; 電子郵件: tengweichen@yahoo.com.tw 化學物質/CAS: Tumor Markers, Biological; alpha-Fetoproteins 參考文獻: Fattovich, G., Stroffolini, T., Zagni, I., Hepatocellular carcinoma in cirrhosis: Incidence and risk factors (2004) Gastroenterology, 127, pp. 35-50; Mullin, E.J., Metcalfe, M.S., Maddern, G.J., How much liver resection is too much? (2005) American Journal of Surgery, 190 (1), pp. 87-97. , DOI 10.1016/j.amjsurg.2005.01.043, PII S0002961005003442; Chau, G.Y., Lui, W.Y., Tsay, S.H., Prognostic significance of surgical margin in hepatocellular carcinoma resection: An analysis of 165 Child's A patients (1997) J Surg Oncol, 66, pp. 122-126; Shi, M., Guo, R.-P., Lin, X.-J., Zhang, Y.-Q., Chen, M.-S., Zhang, C.-Q., Lau, W.Y., Li, J.-Q., Partial hepatectomy with wide versus narrow resection margin for solitary hepatocellular carcinoma: A prospective randomized trial (2007) Annals of Surgery, 245 (1), pp. 36-43. , DOI 10.1097/01.sla.0000231758.07868.71, PII 0000065820070100000007; Hasegawa, K., Kokudo, N., Imamura, H., Matsuyama, Y., Aoki, T., Minagawa, M., Sano, K., Makuuchi, M., Prognostic impact of anatomic resection for hepatocellular carcinoma (2005) Annals of Surgery, 242 (2), pp. 252-259. , DOI 10.1097/01.sla.0000171307.37401.db; Wakai, T., Shirai, Y., Sakata, J., Kaneko, K., Cruz, P.V., Akazawa, K., Hatakeyama, K., Anatomic resection independently improves long-term survival in patients with T1-T2 hepatocellular carcinoma (2007) Annals of Surgical Oncology, 14 (4), pp. 1356-1365. , DOI 10.1245/s10434-006-9318-z; Tanaka, K., Shimada, H., Matsumoto, C., Matsuo, K., Nagano, Y., Endo, I., Togo, S., Anatomic versus limited nonanatomic resection for solitary hepatocellular carcinoma (2008) Surgery, 143 (5), pp. 607-615. , DOI 10.1016/j.surg.2008.01.006, PII S0039606008001177; Greene, F.L., Page, D.L., Fleming, I.D., (2002) AJCC Cancer Staging Manual, , 6th ed. Springer-Verlag New York; The Brisbane 2000 terminology of liver anatomy and resections (2000) HPB, 2, pp. 333-339. , Terminology Committee of the International Hepato-Pancreato-Biliary Association; Makuuchi, M., Hasegawa, H., Yamazaki, S., Ultrasonically guided subsegmentectomy (1985) Surgery Gynecology and Obstetrics, 161 (4), pp. 346-350; Chen, T.W., Chu, C.M., Yu, J.C., Chen, C.J., Chan, D.C., Liu, Y.C., Hsieh, C.B., Comparison of clinical staging systems in predicting survival of hepatocellular carcinoma patients receiving major or minor hepatectomy (2007) European Journal of Surgical Oncology, 33 (4), pp. 480-487. , DOI 10.1016/j.ejso.2006.10.012, PII S0748798306003970; Poon, R.T.-P., Fan, S.-T., Ng, I.O.-L., Wong, J., Significance of resection margin in hepatectomy for hepatocellular carcinoma: A critical reappraisal (2000) Annals of Surgery, 231 (4), pp. 544-551. , DOI 10.1097/00000658-200004000-00014; Ariizumi, S.-I., Yamamoto, M., Ohtsubo, T., Katsuragawa, H., Katagiri, S., Takasaki, K., Step classification is useful for the determination of indications for systematized hepatectomy in hepatocellular carcinoma (2005) Journal of Hepato-Biliary-Pancreatic Surgery, 12 (5), pp. 371-377. , DOI 10.1007/s00534-005-1003-2; Ariizumi, S.-I., Katagiri, S., Katsuragawa, H., Kotera, Y., Yamamoto, M., Sectionectomy is suitable for patients with T2 hepatocellular carcinoma according to the modified international union against cancer TNM classification (2007) Digestive Surgery, 24 (5), pp. 342-348. , DOI 10.1159/000107714; Ochiai, T., Sonoyama, T., Kikuchi, S., Okayama, T., Konishi, H., Kitagawa, M., Tagi, T., Otsuji, E., Anatomic wide hepatectomy for treatment of hepatocellular carcinoma (2007) Journal of Cancer Research and Clinical Oncology, 133 (8), pp. 563-569. , DOI 10.1007/s00432-007-0205-1; Chen, M.F., Hwang, T.L., Jeng, L.B., Postoperative recurrence of hepatocellular carcinoma. Two hundred five consecutive patients who underwent hepatic resection in 15 years (1994) Arch Surg, 129, pp. 738-742; Eguchi, S., Kanematsu, T., Arii, S., Okazaki, M., Okita, K., Omata, M., Ikai, I., Takayasu, K., Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey (2008) Surgery, 143 (4), pp. 469-475. , DOI 10.1016/j.surg.2007.12.003, PII S0039606008000822; Hsieh, C.B., Yu, C.Y., Tzao, C., Chu, H.C., Chen, T.W., Hsieh, H.F., Liu, Y.C., Yu, J.C., Prediction of the risk of hepatic failure in patients with portal vein invasion hepatoma after hepatic resection (2006) European Journal of Surgical Oncology, 32 (1), pp. 72-76. , DOI 10.1016/j.ejso.2005.09.003, PII S0748798305002386; Imamura, H., Sano, K., Sugawara, Y., Kokudo, N., Makuuchi, M., Assessment of hepatic reserve for indication of hepatic resection: Decision tree incorporating indocyanine green test (2005) Journal of Hepato-Biliary-Pancreatic Surgery, 12 (1), pp. 16-22. , DOI 10.1007/s00534-004-0965-9; Cho, Y.B., Lee, K.U., Lee, H.W., Cho, E.-H., Yang, S.-H., Cho, J.Y., Yi, N.-J., Suh, K.-S., Outcomes of hepatic resection for a single large hepatocellular carcinoma (2007) World Journal of Surgery, 31 (4), pp. 795-801. , DOI 10.1007/s00268-006-0359-z; Wakai, T., Shirai, Y., Yokoyama, N., Nagakura, S., Hatakeyama, K., Hepatitis viral status affects the pattern of intrahepatic recurrence after resection for hepatocellular carcinoma (2003) European Journal of Surgical Oncology, 29 (3), pp. 266-271. , DOI 10.1053/ejso.2002.1395; Sakon, M., Umeshita, K., Nagano, H., Clinical significance of hepatic resection in hepatocellular carcinoma: Analysis by disease-free survival curves (2000) Arch Surg, 135, pp. 1546-1549; Imamura, H., Matsuyama, Y., Tanaka, E., Ohkubo, T., Hasegawa, K., Miyagawa, S., Sugawara, Y., Makuuchi, M., Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy (2003) Journal of Hepatology, 38 (2), pp. 200-207. , DOI 10.1016/S0168-8278(02)00360-4; Yanaga, K., Kanematsu, T., Takenaka, K., Matsumata, T., Yoshida, Y., Sugimachi, K., Hepatic resection for hepatocellular carcinoma in elderly patients (1988) American Journal of Surgery, 155 (2), pp. 238-241; Nagasue, N., Chang, Y.-C., Takemoto, Y., Taniura, H., Kohno, H., Nakamura, T., Liver resection in the aged (seventy years or older) with hepatocellular carcinoma (1993) Surgery, 113 (2), pp. 148-154; Huang, J., Li, B.K., Chen, G.H., Long-term outcome and prognostic factors of elderly patients with hepatocellular carcinoma undergoing hepatectomy (2009) J Gastrointest Surg, 13, pp. 1627-1635; Ng, I.O.L., Ng, M.M.T., Lai, E.C.S., Better survival in female patients with hepatocellular carcinoma. Possible causes from a pathologic approach (1995) Cancer, 75, pp. 18-22; Kubo, S., Hirohashi, K., Tanaka, H., Tsukamoto, T., Shuto, T., Yamamoto, T., Ikebe, T., Kinoshita, H., Effect of viral status on recurrence after liver resection for patients with hepatitis B virus-related hepatocellular carcinoma (2000) Cancer, 88 (5), pp. 1016-1024. , DOI 10.1002/(SICI)1097-0142(20000301)88:5<1016::AID-CNCR10>3.0. CO;2-V; Eguchi, S., Ijtsma, A.J.C., Slooff, M.J.H., Porte, R.J., De Jong, K.P., Peeters, P.M.J.G., Gouw, A.S.H., Kanematsu, T., Outcome and pattern of recurrence after curative resection for hepatocellular carcinoma in patients with a normal liver compared to patients with a diseased liver (2006) Hepato-Gastroenterology, 53 (70), pp. 592-596; Yano, M., Hamatani, K., Eguchi, H., Hirai, Y., MacPhee, D.G., Sugino, K., Dohi, K., Asahara, T., Prognosis in patients with hepatocellular carcinoma correlates to mutations of p53 and/or hMSH2 genes (2007) European Journal of Cancer, 43 (6), pp. 1092-1100. , DOI 10.1016/j.ejca.2007.01.032, PII S0959804907001207

PY - 2011

Y1 - 2011

N2 - Synopsis: Major liver resection prevents intrahepatic tumor recurrence in T2 hepatocellular carcinoma patients with microvascular invasion or daughter nodules. Background and Objectives: There is no consensus on whether major or minor hepatectomy is better for hepatocellular carcinoma (HCC) patients. We investigated the outcomes of liver resection type in resectable HCC patients. Methods: Two hundred sixty-three HCC patients with Child-Pugh class A liver function who underwent curative hepatectomy were enrolled. Among them, 186 patients had pathologic stage T1 HCC and 77 had stage T2 HCC. Patients were also classed according to the type of resection (major or minor). Clinicopathologic characteristics and outcomes were compared. Results: Patients with T1 HCC who underwent major resection had a higher rate of blood transfusion than those who underwent minor resection (P <0.001). The disease-free survival rate of T2 patients who underwent major resection was better than that of patients who underwent minor resection (P = 0.004). The overall survival rates of T1 and T2 HCC patients did not differ significantly between those with major or minor resection. Conclusions: Major liver resection is recommended for T2 HCC patients with adequate remnant liver function because it results in a better disease-free survival rate than does minor resection in these patients. Minor liver resection is suggested for T1 HCC patients, except for those with a tumor sitting close to vessels, because it is associated with a low incidence of blood transfusion and a good survival rate. © 2010 Elsevier Ltd. All rights reserved.

AB - Synopsis: Major liver resection prevents intrahepatic tumor recurrence in T2 hepatocellular carcinoma patients with microvascular invasion or daughter nodules. Background and Objectives: There is no consensus on whether major or minor hepatectomy is better for hepatocellular carcinoma (HCC) patients. We investigated the outcomes of liver resection type in resectable HCC patients. Methods: Two hundred sixty-three HCC patients with Child-Pugh class A liver function who underwent curative hepatectomy were enrolled. Among them, 186 patients had pathologic stage T1 HCC and 77 had stage T2 HCC. Patients were also classed according to the type of resection (major or minor). Clinicopathologic characteristics and outcomes were compared. Results: Patients with T1 HCC who underwent major resection had a higher rate of blood transfusion than those who underwent minor resection (P <0.001). The disease-free survival rate of T2 patients who underwent major resection was better than that of patients who underwent minor resection (P = 0.004). The overall survival rates of T1 and T2 HCC patients did not differ significantly between those with major or minor resection. Conclusions: Major liver resection is recommended for T2 HCC patients with adequate remnant liver function because it results in a better disease-free survival rate than does minor resection in these patients. Minor liver resection is suggested for T1 HCC patients, except for those with a tumor sitting close to vessels, because it is associated with a low incidence of blood transfusion and a good survival rate. © 2010 Elsevier Ltd. All rights reserved.

KW - Hepatectomy

KW - Hepatocellular carcinoma

KW - Surgical strategy

KW - Survival

KW - adult

KW - aged

KW - article

KW - blood transfusion

KW - cancer classification

KW - cancer invasion

KW - disease free survival

KW - female

KW - hemihepatectomy

KW - human

KW - liver cell carcinoma

KW - liver function

KW - liver resection

KW - major clinical study

KW - male

KW - morbidity

KW - overall survival

KW - priority journal

KW - prognosis

KW - surgical mortality

KW - treatment outcome

KW - tumor recurrence

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - alpha-Fetoproteins

KW - Carcinoma, Hepatocellular

KW - Disease-Free Survival

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Liver Neoplasms

KW - Male

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Neoplasm Staging

KW - Prognosis

KW - Proportional Hazards Models

KW - Risk Factors

KW - Survival Analysis

KW - Tumor Markers, Biological

U2 - 10.1016/j.ejso.2011.03.004

DO - 10.1016/j.ejso.2011.03.004

M3 - Article

VL - 37

SP - 497

EP - 504

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 6

ER -