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01-10-2019 | Hepatocellular Carcinoma | Original Scientific Report

Clinical Relevance of Reductive Hepatectomy for Barcelona Clinic Liver Cancer Stages B and C Advanced Hepatocellular Carcinoma: A Single-Center Experience of 102 Patients

Authors: Shohei Komatsu, Masahiro Kido, Motofumi Tanaka, Kaori Kuramitsu, ·Daisuke Tsugawa, Masahide Awazu, Hidetoshi Gon, Hirochika Toyama, Kimihiko Ueno, Takumi Fukumoto

Published in: World Journal of Surgery | Issue 10/2019

Abstract

Background

This study aimed to evaluate the clinical relevance of hepatectomy for Barcelona Clinic Liver Cancer (BCLC) stages B and C advanced hepatocellular carcinoma (HCC).

Methods

A total of 314 patients (149 and 165 BCLC stages B and C, respectively) who underwent hepatectomy were included. Complete hepatectomy (without residual tumors after hepatectomy) and reductive hepatectomy (apparent residual tumors after hepatectomy) were performed for 212 and 102 patients, respectively. Short-term operative and postoperative outcomes, as well as long-term outcomes, were evaluated.

Results

The median survival times of patients with stage B disease undergoing complete hepatectomy and reductive hepatectomy were 48.9 and 20.1 months, respectively (p = 0.0075), whereas those of patients with stage C disease were 19.5 and 17.6 months, respectively (p = 0.0140). The 3-year overall survival rates of patients with stage B disease undergoing reductive hepatectomy with and without subsequent local treatments after surgery were 47.5% and 0%, respectively, whereas those of patients with stage C diseases were 18.6% and 0%, respectively.

Conclusions

Survival benefits are obvious for both BCLC stages B and C HCC when complete hepatectomy can be performed safely. Reductive hepatectomy is also acceptable for BCLC stages B and C when subsequent local treatment for remnant liver tumors can be performed safely after reductive hepatectomy. Without subsequent local treatment, reductive hepatectomy has little clinical relevance. Thus, a cautious approach to patient selection is required for this aggressive strategy.

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Title: Clinical Relevance of Reductive Hepatectomy for Barcelona Clinic Liver Cancer Stages B and C Advanced Hepatocellular Carcinoma: A Single-Center Experience of 102 Patients
Authors: Shohei Komatsu
Masahiro Kido
Motofumi Tanaka
Kaori Kuramitsu
·Daisuke Tsugawa
Masahide Awazu
Hidetoshi Gon
Hirochika Toyama
Kimihiko Ueno
Takumi Fukumoto
Publication date: 01-10-2019
Publisher: Springer International Publishing
Keywords: Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: World Journal of Surgery / Issue 10/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05052-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical Relevance of Reductive Hepatectomy for Barcelona Clinic Liver Cancer Stages B and C Advanced Hepatocellular Carcinoma: A Single-Center Experience of 102 Patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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