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World Journal of Surgery

Published in:

01-04-2011

Selection Criteria for Hepatectomy in Patients with Hepatocellular Carcinoma Classified as Child-Pugh Class B

Authors: Shintaro Kuroda, Hirotaka Tashiro, Tsuyoshi Kobayashi, Akihiko Oshita, Hironobu Amano, Hideki Ohdan

Published in: World Journal of Surgery | Issue 4/2011

Abstract

Background

The appropriate surgical approach for hepatocellular carcinoma (HCC) patients of Child-Pugh class B is unclear. The aim of this study was to clarify the prognostic factors after hepatectomy in Child-Pugh class B patients and to delineate the selection criteria for hepatectomy.

Methods

One hundred fifty patients of Child-Pugh class B who underwent hepatectomy were enrolled in this retrospective study (Hx group). Univariate and multivariate analyses were performed to identify prognostic factors. The prognosis was compared with that of 23 patients of Child-Pugh class B who underwent liver transplantation (LT group).

Results

The overall survival rate of the Hx group was significantly worse than that of the LT group (5-year survival: 36.0 vs. 78.3%, p = 0.001). In multivariate analyses, diabetes mellitus (p = 0.011), preoperative total bilirubin level ≥1.5 mg/dl (p = 0.038), and Child-Pugh score of 8 or 9 (p = 0.038) were independent prognostic factors. Although the overall 5-year survival rate of patients with none of the three adverse prognostic factors was only 50.3%, that of patients with one or more adverse prognostic factors was only 27.2% (p = 0.001).

Conclusions

Hepatectomy may be the optimal initial treatment for HCC patients classified as Child-Pugh class B and without any adverse prognostic factors.

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Title: Selection Criteria for Hepatectomy in Patients with Hepatocellular Carcinoma Classified as Child-Pugh Class B
Authors: Shintaro Kuroda
Hirotaka Tashiro
Tsuyoshi Kobayashi
Akihiko Oshita
Hironobu Amano
Hideki Ohdan
Publication date: 01-04-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 4/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-010-0929-y

At a glance: The STEP trials

Springer Medicine

Selection Criteria for Hepatectomy in Patients with Hepatocellular Carcinoma Classified as Child-Pugh Class B

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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