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2015 ; 94
(35
): e1426
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English Wikipedia
Historical Comparison of Overall Survival after Hepatic Resection for Patients
With Large and/or Multinodular Hepatocellular Carcinoma
#MMPMID26334902
Zhong JH
; You XM
; Lu SD
; Wang YY
; Xiang BD
; Ma L
; Wu FX
; Yuan WP
; Chen Y
; Li LQ
Medicine (Baltimore)
2015[Sep]; 94
(35
): e1426
PMID26334902
show ga
The present study compared the efficacy of hepatic resection (HR) in patients
with large hepatocellular carcinoma (HCC) and those with multinodular tumor and
examined how that efficacy has changed over time in a large medical center.The
intermediate stage of HCC comprises a highly heterogeneous patient population.
Moreover, official guidelines have different views on the suitability of HR to
treat such patients.A consecutive sample of 927 patients with preserved liver
function and large and/or multinodular HCC who were treated by initial HR were
divided into 3 groups: those with a single tumor ?5 cm in diameter (n = 588), 2
to 3 tumors with a maximum diameter >3 cm (n? = 225), or >3 tumors of any
diameter (n = 114). Hospital mortality and overall survival (OS) in each group
were compared for the years 2000 to 2007 and 2008 to 2013.Patients with >3 tumors
showed the highest incidence of hospital mortality of all groups (P < 0.05).
Kaplan-Meier survival analysis showed that OS varied across the 3 groups as
follows: single tumor > 2 to 3 tumors > 3+ tumors (all P < 0.05). OS at 5 years
ranged from 24% to 41% in all 3 groups for the period 2000 to 2007, and from 35%
to 46% for the period 2008 to 2013. OS was significantly higher during the more
recent 6-year period in the entire patient population, those with single tumor,
and those with 3+ tumors (all P < 0.05). However, in patients with 2 to 3 tumors,
OS was only slightly higher during the more recent 6-year period (P =
0.084).Prognosis can vary substantially for these 3 types of HCC. Patients with
>3 tumors show the highest hospital mortality and lowest OS after HR. OS has been
improving for all 3 types of HCC at our medical center as a consequence of
improvements in surgical technique and perioperative management.
free
free
free
