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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2008

01-06-2008 | Hepatic and Pancreatic Tumors

Short- and Long-Term Outcomes after Hepatic Resection for Hepatocellular Carcinoma with Concomitant Esophageal Varices in Patients with Cirrhosis

Authors: Yuichiro Kawano, MD, Atsushi Sasaki, MD, Seiichiro Kai, MD, Yuichi Endo, MD, Kentaro Iwaki, MD, Hiroki Uchida, MD, Kohei Shibata, MD, Masayuki Ohta, MD, Seigo Kitano, MD

Published in: Annals of Surgical Oncology | Issue 6/2008

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Abstract

Background

Hepatic resection for hepatocellular carcinoma (HCC) in cirrhotic patients with esophageal varices (EV) is often avoided because of poor liver function reserve. Outcomes of resection in such cases have not been fully investigated.

Methods

We conducted a retrospective study of 134 cirrhotic patients (Child–Pugh class A or B) who underwent hepatic resection for HCC, comparing short- and long-term outcomes in patients with EV (n = 31) to those in patients without EV (n = 103).

Results

Patients with EV had higher tumor differentiation, fewer instances of portal invasion, lower liver function reserve, and more limited resections than did patients without EV. Of 31 patients with EV, four died of postoperative complication, and nine of liver failure, seven of HCC, two of ruptured EV, and two of other causes. Median survival time for patients who died of liver failure was 59 months. Mortality and morbidity rates after hepatic resection did not differ between patients with and without EV. The 5-year overall survival rate was significantly higher in patients with EV (70.1%) than in those without EV (47.5%, P = 0.045) but did not differ between patients without portal invasion with and without EV (P = 0.55). Presence of EV was not an independent predictor for survival.

Conclusions

Short- and long-term outcomes of hepatic resection in HCC patients with and without EV are similar. Limited hepatic resection for early-stage tumor is an option for Child–Pugh class A or B patients with EV.
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Metadata
Title
Short- and Long-Term Outcomes after Hepatic Resection for Hepatocellular Carcinoma with Concomitant Esophageal Varices in Patients with Cirrhosis
Authors
Yuichiro Kawano, MD
Atsushi Sasaki, MD
Seiichiro Kai, MD
Yuichi Endo, MD
Kentaro Iwaki, MD
Hiroki Uchida, MD
Kohei Shibata, MD
Masayuki Ohta, MD
Seigo Kitano, MD
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9880-7

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