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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2016

01-08-2016 | Hepatobiliary Tumors

Hepatectomy for Hepatocellular Carcinoma with Bile Duct Tumor Thrombus, Including Cases with Obstructive Jaundice

Authors: Tatsuya Orimo, MD, PhD, Toshiya Kamiyama, MD, PhD, Hideki Yokoo, MD, PhD, Kenji Wakayama, MD, PhD, Shingo Shimada, MD, PhD, Yosuke Tsuruga, MD, PhD, Hirofumi Kamachi, MD, PhD, Akinobu Taketomi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 8/2016

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Abstract

Background

This study aimed to evaluate the short- and long-term outcomes of hepatectomy for hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT), including cases with obstructive jaundice.

Methods

The study reviewed 42 HCC patients with BDTT, including six patients who needed preoperative biliary drainage due to obstructive jaundice, and 732 HCC patients without BDTT. The authors analyzed the impact of BDTT on the surgical outcomes and assessed the outcomes of hepatectomy for patients presenting with obstructive jaundice.

Results

The HCC patients with BDTT, almost all with stage 3 or 4 disease, had increased alpha-fetoprotein expression, larger tumors, and more portal vein invasion status. The survival of the HCC patients with BDTT was significantly inferior to that of the patients without BDTT (p = 0.0003). Survival did not differ significantly between the HCC patients with BDTT and those without BDTT when the two groups were matched by stage (p = 0.3366). The HCC patients with BDTT who presented with obstructive jaundice demonstrated outcomes similar to those for the HCC patients with BDTT who did not present with obstructive jaundice in terms of the overall survival rate (p = 0.5469). The perioperative outcomes for the HCC patients with BDTT did not depend on the presence or absence of preoperative jaundice. No patients in either BDTT group demonstrated 90-day mortality in this study.

Conclusions

Hepatectomy should be considered for HCC patients with BDTT, even for patients with obstructive jaundice, because the surgical outcomes equivalent to those for HCC without BDTT can be achieved.
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Metadata
Title
Hepatectomy for Hepatocellular Carcinoma with Bile Duct Tumor Thrombus, Including Cases with Obstructive Jaundice
Authors
Tatsuya Orimo, MD, PhD
Toshiya Kamiyama, MD, PhD
Hideki Yokoo, MD, PhD
Kenji Wakayama, MD, PhD
Shingo Shimada, MD, PhD
Yosuke Tsuruga, MD, PhD
Hirofumi Kamachi, MD, PhD
Akinobu Taketomi, MD, PhD
Publication date
01-08-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5174-7

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