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05-12-2022 | Liver Resection | Original Article

Surgical Outcomes for Hepatocellular Carcinoma in Patients with Child–Pugh Class B: a Retrospective Multicenter Study

Authors: Shogo Tanaka, Takehiro Noda, Koji Komeda, Hisashi Kosaka, Hiroya Iida, Masaki Ueno, Daisuke Hokuto, Hisashi Ikoma, Takuya Nakai, Daijiro Kabata, Hiroji Shinkawa, Shogo Kobayashi, Fumitoshi Hirokawa, Haruki Mori, Shinya Hayami, Ryo Morimura, Masataka Matsumoto, Takeaki Ishizawa, Shoji Kubo, Masaki Kaibori

Published in: Journal of Gastrointestinal Surgery | Issue 2/2023

Abstract

Backgrounds

Liver resection for hepatocellular carcinoma (HCC) in patients with Child–Pugh class (CPC) B increases the incidence of postoperative complication and in-hospital death and decreases the disease-free survival (DFS) and overall survival (OS) compared with those with CPC A. Conversely, some selected patients possibly gained benefits for liver resection.

Methods

Clinical records of 114 patients with CPC B who underwent liver resection for HCC were retrospectively reviewed. The risk of postoperative complications (Clavien–Dindo classification grade of ≥ II), postoperative recurrence, and death was analyzed.

Results

Postoperative complications occurred in 36 patients (31.6%), and 2 died within 90 days postoperatively due to the liver and respiratory failure, respectively. Multivariate analysis indicated that albumin-bilirubin (ALB) grade III and extended operation time were found as independent risk factors for postoperative complications. The DFS and OS rates at 3/5 years after liver resection were 30.8%/25.3% and 68.4%/48.9%, respectively. Multivariate analysis indicated that the extended blood loss, high α-fetoprotein (AFP) level (≥ 200 ng/mL), and Barcelona Clinic Liver Cancer stage C were found to be independent risk factors for postoperative recurrence. The high AFP level was also an independent prognostic factor for OS. Patients with high AFP levels had postoperative recurrence within 2 years and a higher number of extrahepatic recurrences than those with low AFP levels (< 200 ng/mL).

Conclusion

For patients with HCC with CPC B who were scheduled for liver resection, ALBI grade III and high AFP level should be considered as unfavorable outcomes after liver resection.

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Title: Surgical Outcomes for Hepatocellular Carcinoma in Patients with Child–Pugh Class B: a Retrospective Multicenter Study
Authors: Shogo Tanaka
Takehiro Noda
Koji Komeda
Hisashi Kosaka
Hiroya Iida
Masaki Ueno
Daisuke Hokuto
Hisashi Ikoma
Takuya Nakai
Daijiro Kabata
Hiroji Shinkawa
Shogo Kobayashi
Fumitoshi Hirokawa
Haruki Mori
Shinya Hayami
Ryo Morimura
Masataka Matsumoto
Takeaki Ishizawa
Shoji Kubo
Masaki Kaibori
Publication date: 05-12-2022
Publisher: Springer US
Keywords: Liver Resection
Liver Resection
Hepatocellular Carcinoma
Ascites
Hepatocellular Carcinoma
Published in: Journal of Gastrointestinal Surgery / Issue 2/2023
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-022-05549-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical Outcomes for Hepatocellular Carcinoma in Patients with Child–Pugh Class B: a Retrospective Multicenter Study

Abstract

Backgrounds

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Backgrounds

Methods

Results

Conclusion

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