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01-02-2018 | ORIGINAL ARTICLE

Liver resection for HCC outside the BCLC criteria

Authors: Manish S. Bhandare, Shraddha Patkar, Nitin Shetty, Ashwin Polnaya, Suyash Kulkarni, Rohit R. Dusane, Shailesh V. Shrikhande, Mahesh Goel

Published in: Langenbeck's Archives of Surgery | Issue 1/2018

Abstract

Purpose

Surgical resection still remains the mainstay of management of hepatocellular carcinoma (HCC). At present, Barcelona clinic liver cancer (BCLC) staging is the most widely used tool to guide treatment; however, criteria for offering surgery as curative treatment are restrictive. We aimed to evaluate short-term and long-term outcomes of HCC after resection, even for patients outside BCLC criteria for resection.

Methods

Data was collected from a prospective database from GI and HPB Department, Tata Memorial Hospital, Mumbai. Study period was from June 2010 to June 2015.

Results

One hundred three patients of HCC were operated during this period, of which 100 underwent complete resection. Patients were staged according to the BCLC classification (BCLC stage A-25, B-64, C-11). Preoperative therapy was administered in 36 (36%) patients. At median follow-up of 21 months, overall 3-year survival for BCLC stages A, B, and C was 55.2, 62.7, and 37.5%, respectively.

Conclusion

In today’s era of liver transplantation, resection (especially for larger tumors) may still be the preferred treatment option, considering problems and difficulties in donor availability, cost, and long waiting list for liver transplant. With evolving modern surgical technique, long-term survival benefit can be achieved with acceptable safety in most BCLC stage B and selected BCLC stage C patients and those who either do not fit into the transplant criteria or cannot afford transplant. Carefully designed trials are required to further elucidate these results.

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Title: Liver resection for HCC outside the BCLC criteria
Authors: Manish S. Bhandare
Shraddha Patkar
Nitin Shetty
Ashwin Polnaya
Suyash Kulkarni
Rohit R. Dusane
Shailesh V. Shrikhande
Mahesh Goel
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 1/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-017-1640-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Liver resection for HCC outside the BCLC criteria

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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