Outcomes of Anterior Approach Major Hepatectomy with Diaphragmatic Resection for Single Huge Right Lobe HCC with Diaphragmatic Invasion

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Sep 12

PMID 30200125

Citations 7

Authors

Jinli Zheng

Shu Shen

Li Jiang

Lunan Yan

Jiayin Yang

Bo Li

Tianfu Wen

WenTao Wang

Mingqing Xu

Affiliations

Soon will be listed here.

Abstract

The outcomes following anterior approach (AA) hepatectomy in huge hepatocellular carcinoma (HCC) patients with diaphragmatic invasion (DI) remain unclear. This study compared the outcomes of single huge right HCC patients with and without DI after AA hepatectomy. A total of 203 consecutive patients with single huge right lobe HCC who underwent AA major hepatectomy were included. They were divided into group PDI (n = 53) and group ADI (n = 150) according to the presence or the absence of DI. Their short- and long-term outcomes were compared, and a subgroup analysis was performed. There were no significant differences regarding postoperative complications and 90-day mortality between the 2 groups. The overall survival (OS) and recurrence-free survival (RFS) rates were similar between the 2 groups. The subgroup analysis also showed that patients with tumor resection en bloc with part of the diaphragm had similar OS and RFS rates as those who underwent diaphragmatic resection after hepatectomy. Tumor diameter ≥ 15 cm, serum AFP level ≥ 400 ng/mL, and tumor grade of G4 and microvascular invasion are independent predictors of poor prognosis. For the single huge right lobe HCC patients with DI, AA major hepatectomy combined with diaphragmatic resection could offer similar OS and RFS as those without diaphragmatic invasion.

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References

Zhang H, Yuan S, Dai S, Zhang J, Huang X, Lu C . Tumor size does not independently affect long-term survival after curative resection of solitary hepatocellular carcinoma without macroscopic vascular invasion. World J Surg. 2013; 38(4):947-57. DOI: 10.1007/s00268-013-2365-2. View

Jemal A, Bray F, Center M, Ferlay J, Ward E, Forman D . Global cancer statistics. CA Cancer J Clin. 2011; 61(2):69-90. DOI: 10.3322/caac.20107. View

Pawlik T, Poon R, Abdalla E, Zorzi D, Ikai I, Curley S . Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg. 2005; 140(5):450-7. DOI: 10.1001/archsurg.140.5.450. View

Wang C, Jawade K, Yap A, Concejero A, Lin C, Chen C . Resection of large hepatocellular carcinoma using the combination of liver hanging maneuver and anterior approach. World J Surg. 2010; 34(8):1874-8. DOI: 10.1007/s00268-010-0546-9. View

Minagawa M, Ikai I, Matsuyama Y, Yamaoka Y, Makuuchi M . Staging of hepatocellular carcinoma: assessment of the Japanese TNM and AJCC/UICC TNM systems in a cohort of 13,772 patients in Japan. Ann Surg. 2007; 245(6):909-22. PMC: 1876960. DOI: 10.1097/01.sla.0000254368.65878.da. View

Bruix J, Gores G, Mazzaferro V . Hepatocellular carcinoma: clinical frontiers and perspectives. Gut. 2014; 63(5):844-55. PMC: 4337888. DOI: 10.1136/gutjnl-2013-306627. View

Shin E, Yu Y, Kim D, Won N . Adiponectin receptor expression predicts favorable prognosis in cases of hepatocellular carcinoma. Pathol Oncol Res. 2014; 20(3):667-75. DOI: 10.1007/s12253-014-9747-0. View

Li Y, Xia Y, Li J, Wu D, Wan X, Wang K . Prognostic Nomograms for Pre- and Postoperative Predictions of Long-Term Survival for Patients Who Underwent Liver Resection for Huge Hepatocellular Carcinoma. J Am Coll Surg. 2015; 221(5):962-974.e4. DOI: 10.1016/j.jamcollsurg.2015.08.003. View

Santambrogio R, Kluger M, Costa M, Belli A, Barabino M, Laurent A . Hepatic resection for hepatocellular carcinoma in patients with Child-Pugh's A cirrhosis: is clinical evidence of portal hypertension a contraindication?. HPB (Oxford). 2012; 15(1):78-84. PMC: 3533715. DOI: 10.1111/j.1477-2574.2012.00594.x. View

10.

Forner A, Gilabert M, Bruix J, Raoul J . Treatment of intermediate-stage hepatocellular carcinoma. Nat Rev Clin Oncol. 2014; 11(9):525-35. DOI: 10.1038/nrclinonc.2014.122. View

11.

Colecchia A, Scaioli E, Montrone L, Vestito A, Di Biase A, Pieri M . Pre-operative liver biopsy in cirrhotic patients with early hepatocellular carcinoma represents a safe and accurate diagnostic tool for tumour grading assessment. J Hepatol. 2010; 54(2):300-5. DOI: 10.1016/j.jhep.2010.06.037. View

12.

Komatsu S, Murakami M, Fukumoto T, Hori Y, Hishikawa Y, Ku Y . Risk factors for survival and local recurrence after particle radiotherapy for single small hepatocellular carcinoma. Br J Surg. 2011; 98(4):558-64. DOI: 10.1002/bjs.7397. View

13.

Yao F, Ferrell L, Bass N, Watson J, Bacchetti P, Venook A . Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001; 33(6):1394-403. DOI: 10.1053/jhep.2001.24563. View

14.

Lau W, Leung K, Leung T, Liew C, Chan M, Li A . Resection of hepatocellular carcinoma with diaphragmatic invasion. Br J Surg. 1995; 82(2):264-6. DOI: 10.1002/bjs.1800820242. View

15.

Chan A, Fan S, Poon R, Cheung T, Chok K, Chan S . Evaluation of the seventh edition of the American Joint Committee on Cancer tumour-node-metastasis (TNM) staging system for patients undergoing curative resection of hepatocellular carcinoma: implications for the development of a refined staging.... HPB (Oxford). 2013; 15(6):439-48. PMC: 3664048. DOI: 10.1111/j.1477-2574.2012.00617.x. View

16.

. [Recommendation on antiviral therapy to hepatitis B/C virus related hepatocellular carcinoma]. Zhonghua Gan Zang Bing Za Zhi. 2013; 21(2):96-100. View

17.

Cucchetti A, Sposito C, Pinna A, Citterio D, Ercolani G, Flores M . Effect of age on survival in patients undergoing resection of hepatocellular carcinoma. Br J Surg. 2015; 103(2):e93-9. DOI: 10.1002/bjs.10056. View

18.

Goh B, Kam J, Lee S, Chan C, Allen J, Jeyaraj P . Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and prognostic nutrition index as preoperative predictors of early mortality after liver resection for huge (≥10 cm) hepatocellular carcinoma. J Surg Oncol. 2016; 113(6):621-7. DOI: 10.1002/jso.24197. View

19.

Liao W, Zhang J, Zhu Q, Qin L, Yao W, Lei B . Preoperative Neutrophil-to-Lymphocyte Ratio as a New Prognostic Marker in Hepatocellular Carcinoma after Curative Resection. Transl Oncol. 2014; 7(2):248-55. PMC: 4101343. DOI: 10.1016/j.tranon.2014.02.011. View

20.

Min Y, Lee J, Gwak G, Paik Y, Lee J, Rhee P . Long-term survival after surgical resection for huge hepatocellular carcinoma: comparison with transarterial chemoembolization after propensity score matching. J Gastroenterol Hepatol. 2014; 29(5):1043-8. DOI: 10.1111/jgh.12504. View