Long-term outcomes after hepatectomy of huge hepatocellular carcinoma: A single-center experience in China
Currently, hepatectomy remains the first-line therapy for hepatocellular carcinoma (HCC). However, surgery for patients with huge (>10 cm) HCCs is controversial. This retrospective study aimed to explore long-term survival after hepatectomy for patients with huge HCC. The records of 188 patients...
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| Veröffentlicht in: | Hepatobiliary & pancreatic diseases international 2019-12, Vol.18 (6), p.532-537 |
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| creator | Fang, Qiang Xie, Qing-Song Chen, Jiang-Ming Shan, Shen-Liang Xie, Kun Geng, Xiao-Ping Liu, Fu-Bao |
| description | Currently, hepatectomy remains the first-line therapy for hepatocellular carcinoma (HCC). However, surgery for patients with huge (>10 cm) HCCs is controversial. This retrospective study aimed to explore long-term survival after hepatectomy for patients with huge HCC.
The records of 188 patients with pathologically confirmed HCC who underwent curative hepatectomy between 2007 and 2017 were reviewed; patients were divided into three groups according to tumor size: huge (>10 cm; n = 84), large (5–10 cm; n = 51) and small (10 cm) had significant effect on OS, and postoperative antiviral therapy and postoperative complications also had significant effects on DFS.
Huge HCC is not a contraindication of hepatectomy. Although most of these patients experienced recurrence after surgery, OS and DFS were not significantly different from those of patients with large HCC after resection. |
| doi_str_mv | 10.1016/j.hbpd.2019.09.001 |
| format | Article |
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The records of 188 patients with pathologically confirmed HCC who underwent curative hepatectomy between 2007 and 2017 were reviewed; patients were divided into three groups according to tumor size: huge (>10 cm; n = 84), large (5–10 cm; n = 51) and small (<5 cm; n = 53) HCC. Kaplan-Meier analysis was used to assess overall survival (OS) and disease-free survival (DFS), and log-rank analysis was performed for pairwise comparisons among the three groups. Risk factors for survival and recurrence were analyzed using the Cox proportional hazard model.
The median follow-up period was 20 months. Although the prognosis of small HCC was better than that of huge and large HCC, OS and DFS were not significantly different between huge and large HCC (P = 0.099 and P = 0.831, respectively). A family history of HCC, poor Child-Pugh class, vascular invasion, diolame, pathologically positive margins, and operative time ≥240 min were identified as independent risk factors for OS and DFS in a multivariate model. Tumor size (>10 cm) had significant effect on OS, and postoperative antiviral therapy and postoperative complications also had significant effects on DFS.
Huge HCC is not a contraindication of hepatectomy. Although most of these patients experienced recurrence after surgery, OS and DFS were not significantly different from those of patients with large HCC after resection.</description><identifier>ISSN: 1499-3872</identifier><identifier>DOI: 10.1016/j.hbpd.2019.09.001</identifier><identifier>PMID: 31543313</identifier><language>eng</language><publisher>Singapore: Elsevier B.V</publisher><subject>Adult ; Aged ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; China ; Female ; Hepatectomy - adverse effects ; Hepatectomy - mortality ; Hepatocellular carcinoma ; Humans ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Male ; Middle Aged ; Prognosis ; Progression-Free Survival ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Surgical resection ; Time Factors ; Tumor Burden ; Young Adult</subject><ispartof>Hepatobiliary & pancreatic diseases international, 2019-12, Vol.18 (6), p.532-537</ispartof><rights>2019</rights><rights>Copyright © 2019. Published by Elsevier B.V.</rights><rights>Copyright © Wanfang Data Co. Ltd. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-b138b4f74f1cb539a065e7611346fac3995fab3e3c55a7e51cf87b73b7e13623</citedby><cites>FETCH-LOGICAL-c392t-b138b4f74f1cb539a065e7611346fac3995fab3e3c55a7e51cf87b73b7e13623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://www.wanfangdata.com.cn/images/PeriodicalImages/gjgdybzz-z/gjgdybzz-z.jpg</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1499387219301791$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31543313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fang, Qiang</creatorcontrib><creatorcontrib>Xie, Qing-Song</creatorcontrib><creatorcontrib>Chen, Jiang-Ming</creatorcontrib><creatorcontrib>Shan, Shen-Liang</creatorcontrib><creatorcontrib>Xie, Kun</creatorcontrib><creatorcontrib>Geng, Xiao-Ping</creatorcontrib><creatorcontrib>Liu, Fu-Bao</creatorcontrib><title>Long-term outcomes after hepatectomy of huge hepatocellular carcinoma: A single-center experience in China</title><title>Hepatobiliary & pancreatic diseases international</title><addtitle>Hepatobiliary Pancreat Dis Int</addtitle><description>Currently, hepatectomy remains the first-line therapy for hepatocellular carcinoma (HCC). However, surgery for patients with huge (>10 cm) HCCs is controversial. This retrospective study aimed to explore long-term survival after hepatectomy for patients with huge HCC.
The records of 188 patients with pathologically confirmed HCC who underwent curative hepatectomy between 2007 and 2017 were reviewed; patients were divided into three groups according to tumor size: huge (>10 cm; n = 84), large (5–10 cm; n = 51) and small (<5 cm; n = 53) HCC. Kaplan-Meier analysis was used to assess overall survival (OS) and disease-free survival (DFS), and log-rank analysis was performed for pairwise comparisons among the three groups. Risk factors for survival and recurrence were analyzed using the Cox proportional hazard model.
The median follow-up period was 20 months. Although the prognosis of small HCC was better than that of huge and large HCC, OS and DFS were not significantly different between huge and large HCC (P = 0.099 and P = 0.831, respectively). A family history of HCC, poor Child-Pugh class, vascular invasion, diolame, pathologically positive margins, and operative time ≥240 min were identified as independent risk factors for OS and DFS in a multivariate model. Tumor size (>10 cm) had significant effect on OS, and postoperative antiviral therapy and postoperative complications also had significant effects on DFS.
Huge HCC is not a contraindication of hepatectomy. Although most of these patients experienced recurrence after surgery, OS and DFS were not significantly different from those of patients with large HCC after resection.</description><subject>Adult</subject><subject>Aged</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>China</subject><subject>Female</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - mortality</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Progression-Free Survival</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Surgical resection</subject><subject>Time Factors</subject><subject>Tumor Burden</subject><subject>Young Adult</subject><issn>1499-3872</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhb0AtWXKC7BAXiKhDP5J4gSxqUYtrTQSm-4tx7nOOErsYCfAzNPjkMIS6UqWre-cK5-D0DtK9pTQ8lO_PzVTu2eE1nuShtBX6IbmdZ3xSrBr9CbGnhBWVUV5ha45LXLOKb9B_dG7LpshjNgvs_YjRKxMuuMTTGoGPfvxjL3Bp6WD7c1rGIZlUAFrFbR1flSf8R2O1nUDZBrcqoZfEwQLTgO2Dh9O1qlb9NqoIcLbl3OHnh_unw-P2fHb16fD3THTvGZz1lBeNbkRuaG6KXitSFmAKCnleWlUYurCqIYD10WhBBRUm0o0gjcCKC8Z36GPm-1P5Yxynez9ElxaKLu-a8_N5SIva0ykJEQk-sNGT8F_XyDOcrRx_aBy4JcoGavTasFSXjvENlQHH2MAI6dgRxXOkhK5liB7uZYgV3dJ0hCaRO9f_JdmhPaf5G8DCfiyAZAi-WEhyKj_5NbakNKXrbf_8_8N79ibOA</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Fang, Qiang</creator><creator>Xie, Qing-Song</creator><creator>Chen, Jiang-Ming</creator><creator>Shan, Shen-Liang</creator><creator>Xie, Kun</creator><creator>Geng, Xiao-Ping</creator><creator>Liu, Fu-Bao</creator><general>Elsevier B.V</general><general>Division of General Surgery, First Affiliated Hospital, Anhui Medical University, Hefei 230022, China</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope></search><sort><creationdate>20191201</creationdate><title>Long-term outcomes after hepatectomy of huge hepatocellular carcinoma: A single-center experience in China</title><author>Fang, Qiang ; Xie, Qing-Song ; Chen, Jiang-Ming ; Shan, Shen-Liang ; Xie, Kun ; Geng, Xiao-Ping ; Liu, Fu-Bao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c392t-b138b4f74f1cb539a065e7611346fac3995fab3e3c55a7e51cf87b73b7e13623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>China</topic><topic>Female</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - mortality</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Progression-Free Survival</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Surgical resection</topic><topic>Time Factors</topic><topic>Tumor Burden</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fang, Qiang</creatorcontrib><creatorcontrib>Xie, Qing-Song</creatorcontrib><creatorcontrib>Chen, Jiang-Ming</creatorcontrib><creatorcontrib>Shan, Shen-Liang</creatorcontrib><creatorcontrib>Xie, Kun</creatorcontrib><creatorcontrib>Geng, Xiao-Ping</creatorcontrib><creatorcontrib>Liu, Fu-Bao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Wanfang Data Journals - Hong Kong</collection><collection>WANFANG Data Centre</collection><collection>Wanfang Data Journals</collection><collection>万方数据期刊 - 香港版</collection><collection>China Online Journals (COJ)</collection><collection>China Online Journals (COJ)</collection><jtitle>Hepatobiliary & pancreatic diseases international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fang, Qiang</au><au>Xie, Qing-Song</au><au>Chen, Jiang-Ming</au><au>Shan, Shen-Liang</au><au>Xie, Kun</au><au>Geng, Xiao-Ping</au><au>Liu, Fu-Bao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term outcomes after hepatectomy of huge hepatocellular carcinoma: A single-center experience in China</atitle><jtitle>Hepatobiliary & pancreatic diseases international</jtitle><addtitle>Hepatobiliary Pancreat Dis Int</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>18</volume><issue>6</issue><spage>532</spage><epage>537</epage><pages>532-537</pages><issn>1499-3872</issn><abstract>Currently, hepatectomy remains the first-line therapy for hepatocellular carcinoma (HCC). However, surgery for patients with huge (>10 cm) HCCs is controversial. This retrospective study aimed to explore long-term survival after hepatectomy for patients with huge HCC.
The records of 188 patients with pathologically confirmed HCC who underwent curative hepatectomy between 2007 and 2017 were reviewed; patients were divided into three groups according to tumor size: huge (>10 cm; n = 84), large (5–10 cm; n = 51) and small (<5 cm; n = 53) HCC. Kaplan-Meier analysis was used to assess overall survival (OS) and disease-free survival (DFS), and log-rank analysis was performed for pairwise comparisons among the three groups. Risk factors for survival and recurrence were analyzed using the Cox proportional hazard model.
The median follow-up period was 20 months. Although the prognosis of small HCC was better than that of huge and large HCC, OS and DFS were not significantly different between huge and large HCC (P = 0.099 and P = 0.831, respectively). A family history of HCC, poor Child-Pugh class, vascular invasion, diolame, pathologically positive margins, and operative time ≥240 min were identified as independent risk factors for OS and DFS in a multivariate model. Tumor size (>10 cm) had significant effect on OS, and postoperative antiviral therapy and postoperative complications also had significant effects on DFS.
Huge HCC is not a contraindication of hepatectomy. Although most of these patients experienced recurrence after surgery, OS and DFS were not significantly different from those of patients with large HCC after resection.</abstract><cop>Singapore</cop><pub>Elsevier B.V</pub><pmid>31543313</pmid><doi>10.1016/j.hbpd.2019.09.001</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Aged Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery China Female Hepatectomy - adverse effects Hepatectomy - mortality Hepatocellular carcinoma Humans Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Male Middle Aged Prognosis Progression-Free Survival Retrospective Studies Risk Assessment Risk Factors Surgical resection Time Factors Tumor Burden Young Adult |
| title | Long-term outcomes after hepatectomy of huge hepatocellular carcinoma: A single-center experience in China |
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