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01-07-2013 | Hepatobiliary Tumors

Infection with Hepatitis C Virus is an Adverse Prognostic Factor after Liver Resection for Early-stage Hepatocellular Carcinoma

Implications for the Management of Hepatocellular Carcinoma Eligible for Liver Transplantation

Authors: Mircea Chirica, MD, Hadrien Tranchart, MD, Viriane Tan, MD, Matthieu Faron, MD, Pierre Balladur, MD, PhD, François Paye, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2013

Abstract

Introduction

Recent data support liver resection (LR) as first-line approach in patients with preserved liver function who have resectable/transplantable hepatocellular carcinoma (HCC). This study was designed to evaluate the outcome of LR in patients with transplantable HCC.

Methods

Between 1998 and 2009, 75 patients (65 men, mean age 61 ± 11 years) with HCC eligible for liver transplantation (LT) underwent LR. The underlying hepatic disease was related to hepatitis C (HCV) in 30 (40 %) patients, hepatitis B (HBV) in 15 (20 %) patients, alcohol abuse in 26 patients (36 %) and other in 10 patients (13 %). Fifty-five (73 %) patients had cirrhosis. Intermittent clamping of the hepatic pedicle was used in 41 (55 %) patients. Treatment of recurrence by salvage LT was performed in 6 (8 %) patients.

Results

Operative morbidity and mortality rates were 37 and 5 % respectively. At 1, 3, and 5 years, overall (OS) and disease-free (DFS) survival rates were 81, 69,55 and 56, 31, and 21 %, respectively. On multivariate analysis, HCV infection was the only independent factor associated with decreased OS (p = 0.02). On multivariate analysis, HCV infection (p = 0.05) and intermittent hepatic pedicle clamping (p = 0.003) were associated with decreased DFS. The 1-, 3-, and 5-year OS and DFS rates in patients with HCV-related HCC were 69, 53, 38 and 50, 18, and 9% respectively.

Conclusions

Overall and disease-free survival after liver resection in patients with HCV-related HCC and preserved liver function is poor. Primary LT should be offered to these patients.

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Title: Infection with Hepatitis C Virus is an Adverse Prognostic Factor after Liver Resection for Early-stage Hepatocellular Carcinoma
Implications for the Management of Hepatocellular Carcinoma Eligible for Liver Transplantation
Authors: Mircea Chirica, MD
Hadrien Tranchart, MD
Viriane Tan, MD
Matthieu Faron, MD
Pierre Balladur, MD, PhD
François Paye, MD, PhD
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 7/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2861-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Infection with Hepatitis C Virus is an Adverse Prognostic Factor after Liver Resection for Early-stage Hepatocellular Carcinoma

Implications for the Management of Hepatocellular Carcinoma Eligible for Liver Transplantation

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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