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Published in: Langenbeck's Archives of Surgery 7/2018

01-11-2018 | ORIGINAL ARTICLE

Prognostic factors of disease-free and overall survival in patients with hepatocellular carcinoma undergoing partial hepatectomy in curative intent

Authors: Georg Lurje, Jan Bednarsch, Zoltan Czigany, Iakovos Amygdalos, Franziska Meister, Wenzel Schöning, Tom Florian Ulmer, Martin Foerster, Cornelis Dejong, Ulf Peter Neumann

Published in: Langenbeck's Archives of Surgery | Issue 7/2018

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Abstract

Purpose

Tumor recurrence after liver resection continues to pose a major problem in hepatocellular carcinoma (HCC). Here we aimed to evaluate prognostic markers for disease-free (DFS) and overall survival (OS) in HCC-patients who underwent liver resection in curative intent. Additionally, we investigated the effects of HCC-recurrence in a subgroup of patients.

Methods

Between 2010 and 2016, 111 patients underwent surgical resection for HCC at our institution. A subgroup of 50 patients showed tumor recurrence (n = 50) during follow-up. The associations of DFS and OS with histopathologic characteristics were assessed using univariable and multivariable Cox regression analyses.

Results

Median DFS was 31 months and median OS was 27 months. Milan criteria (p = 0.045), macrovascular invasion (p = 0.044) and UICC tumor stage (p = 0.003) were independently associated with DFS while macrovascular invasion (p = 0.001) and MELD score (p = 0.010) were independently associated with OS. Tumor recurrence did not show an association with OS (p = 0.228). However, patients with HCC-recurrence who underwent repeat-surgical or interventional treatment showed improved OS compared to patients treated with palliative or sorafenib treatment alone (OS 18 months vs. 2 months; p < 0.001).

Conclusion

Tumor recurrence alone is not associated with poor oncological outcome and repeat liver resections as well as local-ablative procedures may help to improve OS in HCC.
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Metadata
Title
Prognostic factors of disease-free and overall survival in patients with hepatocellular carcinoma undergoing partial hepatectomy in curative intent
Authors
Georg Lurje
Jan Bednarsch
Zoltan Czigany
Iakovos Amygdalos
Franziska Meister
Wenzel Schöning
Tom Florian Ulmer
Martin Foerster
Cornelis Dejong
Ulf Peter Neumann
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 7/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-018-1715-9

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