Hepatocellular carcinoma in cirrhotic patients with portal hypertension：Is liver resection always contraindicated

AIM：To analyze the outcome of hepatocellular car-cinoma（HCC）resection in cirrhosis patients,related to presence of portal hypertension（PH）and extent of hepatectomy.METHODS：A retrospective analysis of 135 patients with HCC on a background of cirrhosis was submitted to curative liver resection.RESULTS：PH was present in 44（32.5%）patients.Overall mortality and morbidity were 2.2% and 33.7%,respectively.Median survival time in patients with or without PH was 31.6 and 65.1 mo,respectively（P=0.047）;in the subgroup with Child-Pugh class A cirrhosis,median survival was 65.1 mo and 60.5 mo,respectively（P=0.257）.Survival for patients submitted to limited liver resection was not significantly different in presence or absence of PH.Conversely,median survival for patients after resection of 2 or more segments with or without PH was 64.4 mo and 163.9 mo,respectively（P=0.035）.CONCLUSION：PH is not an absolute contraindication to liver resection in Child-Pugh class A cirrhotic patients,but resection of 2 or more segments should not be recommended in patients with PH.