Patient Age and Extent of Liver Resection Influence Outcome of Liver Resection for Hepatocellular Carcinoma in Non-Cirrhotic Liver

被引:9
|
作者
Faber, Wladimir [1 ]
Sharafi, Siamak [1 ]
Stockmann, Martin [1 ]
Dennecke, Timm [2 ]
Bahra, Marcus [1 ]
Klein, Fritz [1 ]
Malinowski, Maciej B. [1 ]
Schott, Eckart [3 ]
Neuhaus, Peter [1 ]
Seehofer, Daniel [1 ]
机构
[1] Charite, Dept Gen Visceral & Transplantat Surg, Campus Virchow Klinikum, D-13353 Berlin, Germany
[2] Charite, Dept Radiol, D-13353 Berlin, Germany
[3] Charite, Dept Hepatol, D-13353 Berlin, Germany
关键词
Liver; hepatocellular carcinoma; clinical course; LONG-TERM SURVIVAL; PROGNOSTIC-FACTORS; HEPATIC RESECTION; NONALCOHOLIC STEATOHEPATITIS; CANCER; TRANSPLANTATION; CIRRHOSIS; RISK; CLASSIFICATION; RECURRENCE;
D O I
10.5754/hge13667
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Backgrouind/Aims: Data about the clinical course after liver resection for HCC in non-cirrhotic liver (NCL) is rare in western countries. Although the patients with HCC in NCL tolerate major liver resections, it is less clear if an underlying steatosis or NASH increase the perioperative and postoperative risk. The purpose of this study was to characterize the clinical course after hepatic re!section in patients with HCC in the absence of liver cirrhosis and in the absence of viral hepatitis. Methodology: The data of 148 patients with HCC in non-cirrhotic liver, who underwent curatively intented liver resection, were analyzed. Patients with hepatitis B or C infection were excluded. Patients with fibrolamellar HCC or liver cirrhosis or fibrosis higher than grade 2 according to the Desmet-Scheuer score were also excluded. Results: 'The overall 1-, 3- and 5-year survival rates were 75.4%, 54.7% and 38.9%. Increased patient age (elder than 70 years) influenced the cumulative survival significantly. Especially the combination of increased patient age and major resection (>2 segments) at once influenced tliel cumulative survival. The overall postoperative morbidity was 37.8 %. No intraoperative death was observed Postoperative increased leucocytes, urea and creatininl increased the postoperative complications. In the subi group with major resection increased GGT correlated: with steatosis, and raised AST correlated with elevated ! patient age. Conclusions: In Western countries HCC non-cirrhotic liver is rare. Liver resection is safe and is the only curative therapy option for the time by HCCI without liver cirrhosis. Further studies are necessary] for identification of more prognostic factors and option.' ally special treatment.
引用
收藏
页码:1925 / 1930
页数:6
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