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01-08-2018 | Original Scientific Report

Surgery for Hepatocellular Carcinoma in Patients with Child–Pugh B Cirrhosis: Hepatic Resection Versus Living Donor Liver Transplantation

Authors: Norifumi Harimoto, Tomoharu Yoshizumi, Yukiko Fujimoto, Takashi Motomura, Youhei Mano, Takeo Toshima, Shinji Itoh, Noboru Harada, Toru Ikegami, Hideaki Uchiyama, Yuji Soejima, Yoshihiko Maehara

Published in: World Journal of Surgery | Issue 8/2018

Abstract

Background

Liver transplantation has been established as the optimal treatment for hepatocellular carcinoma in cirrhotic patients, but hepatic resection is also effective in patients with well-preserved liver function. Determining the suitable surgical treatment for patients with Child–Pugh class B cirrhosis is a more difficult challenge.

Methods

We retrospectively compared the results of hepatic resection and living donor liver transplantation for hepatocellular carcinoma in 137 patients with Child–Pugh class B cirrhosis. The procedures were performed at Kyushu University Hospital from April 2014 through October 2016.

Results

Patients who underwent hepatic resection were significantly older and had better liver function, larger tumor size, smaller number of tumors, and less surgical stress compared with patients who underwent living donor liver transplantation. The overall survival rate and the recurrence-free survival rate in patients with transplantation were significantly better than that in patients with resection. The multivariate analysis showed that recurrent hepatocellular carcinoma and microvascular invasion were significant prognostic factors for both overall and recurrence-free survival in the hepatic resection group. In the group with protein induced by vitamin K absence or antagonist-II ≥300 mAU/mL, both the overall survival curve and the recurrence-free survival curve in patients with living donor liver transplantation were not significantly different from those in patients with hepatic resection.

Conclusions

Living donor liver transplantation for hepatocellular carcinoma in patients with Child–Pugh class B cirrhosis was favorable under the condition of protein induced by vitamin K absence or antagonist-II <300 mAU/mL in selected recipients and donors. Hepatic resection for recurrent hepatocellular carcinoma and excessive blood loss should be avoided in patients with Child–Pugh class B cirrhosis.

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Title: Surgery for Hepatocellular Carcinoma in Patients with Child–Pugh B Cirrhosis: Hepatic Resection Versus Living Donor Liver Transplantation
Authors: Norifumi Harimoto
Tomoharu Yoshizumi
Yukiko Fujimoto
Takashi Motomura
Youhei Mano
Takeo Toshima
Shinji Itoh
Noboru Harada
Toru Ikegami
Hideaki Uchiyama
Yuji Soejima
Yoshihiko Maehara
Publication date: 01-08-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 8/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4493-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgery for Hepatocellular Carcinoma in Patients with Child–Pugh B Cirrhosis: Hepatic Resection Versus Living Donor Liver Transplantation

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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