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01-07-2009 | Hepatobiliary and Pancreatic Tumors

Perioperative Factors Affecting Long-Term Outcomes of 473 Consecutive Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

Authors: Chih-Chi Wang, MD, Shridhar G. Iyer, FRCS, Jee Keem Low, MD, FRCS, Chih-Yun Lin, MS, Shih-Ho Wang, MD, Sen-Nan Lu, MD, Chao-Long Chen, MD

Published in: Annals of Surgical Oncology | Issue 7/2009

Abstract

Background

The aim of this study was to evaluate the long-term outcomes of liver resection for hepatocellular carcinoma (HCC).

Methods

Between January 1993 and December 2002, a total of 473 patients underwent hepatectomy for HCC at a medical center in Taiwan. Clinicopathological and surgical characteristics were studied to identify prognostic factors influencing survival.

Results

There were 379 men (80.1%) with mean ± standard deviation age of 53.1 ± 13.1 years. The etiology of HCC was hepatitis B (n = 277), hepatitis C (n = 90), coinfection with hepatitis B and C (n = 47), and non–B or C hepatitis (n = 50). The blood loss was 282.3 ± 370.5 ml, and 411 patients (86.9%) did not require perioperative blood transfusion. On univariate analysis, the statistically significant independent factors for disease-free survival were alfa-fetoprotein (AFP) levels of >400 ng/ml, indocyanine green retention of >10%, Pringle maneuver, blood transfusion, tumor diameter >5 cm, bilateral tumors, microvascular invasion, adjacent tissue invasion, daughter nodules and cirrhotic liver. The univariate factors influencing overall survival were similar to those influencing disease-free survival except for AFP. Independent factors that statistically significantly affected overall survival on multivariate analysis included Pringle maneuver, blood transfusion, tumor diameter >3 cm, microvascular invasion, daughter nodules, and liver cirrhosis. The 1-, 5-, and 10-year disease-free survival were 75.3, 43.3, and 22.3%, respectively. The 1-, 5-, and 10-year overall survival were 86.7, 55, and 33.7%, respectively.

Conclusions

AFP, indocyanine green retention of >10%, blood transfusion, Pringle maneuver, tumor diameter of >3 cm, bilateral tumors, microvascular invasion, adjacent tissue invasion, daughter nodules, and liver cirrhosis influence survival.

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Title: Perioperative Factors Affecting Long-Term Outcomes of 473 Consecutive Patients Undergoing Hepatectomy for Hepatocellular Carcinoma
Authors: Chih-Chi Wang, MD
Shridhar G. Iyer, FRCS
Jee Keem Low, MD, FRCS
Chih-Yun Lin, MS
Shih-Ho Wang, MD
Sen-Nan Lu, MD
Chao-Long Chen, MD
Publication date: 01-07-2009
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 7/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-009-0448-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perioperative Factors Affecting Long-Term Outcomes of 473 Consecutive Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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