Outcomes of Curative Liver Resection for Hepatocellular Carcinoma in Patients with Cirrhosis

Overview

Journal World J Gastrointest Oncol

Publisher Baishideng Publishing Group

Date 2021 May 27

PMID 34040703

Citations 7

Authors

Omar Elshaarawy

Aya Aman

Hazem Mohamed Zakaria

Talaat Zakareya

Asmaa Gomaa

Esam Elshimi

Eman Abdelsameea

Affiliations

Soon will be listed here.

Abstract

Background: Given the poor synthetic function of cirrhotic liver, successful resection for patients with hepatocellular carcinoma (HCC) necessitates the ability to achieve resections with tumor free margins.

Aim: To validate post hepatectomy liver failure score (PHLF), compare it to other established systems and to stratify risks in patients with cirrhosis who underwent curative liver resection for HCC.

Methods: Between December 2010 and January 2017, 120 patients underwent curative resection for HCC in patients with cirrhosis were included, the pre-operative, operative and post-operative factors were recorded to stratify patients' risks of decompensation, survival, and PHLF.

Results: The preoperative model for end-stage liver disease (MELD) score [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, = 0.013], tumor diameter (OR = 5.4, 95%CI: 2-14.8, = 0.001) and duration of hospital stay (OR = 2.5, 95%CI: 1.5-4.2, = 0.001) were significant independent predictors of hepatic decompensation after resection. While the preoperative MELD score [hazard ratio (HR) = 1.37, 95%CI: 1.16-1.62, < 0.001] and different grades of PHLF (grade A: HR = 2.33, 95%CI: 0.59-9.24; Grade B: HR = 3.15, 95%CI: 1.11-8.95; Grade C: HR = 373.41, 95%CI: 66.23-2105.43; < 0.001) and HCC recurrence (HR = 11.67, 95%CI: 4.19-32.52, < 0.001) were significant independent predictors for survival.

Conclusion: Preoperative MELD score and tumor diameter can independently predict hepatic decompensation. While, preoperative MELD score, different grades of PHLF and HCC recurrence can precisely predict survival.

Citing Articles

Controlled low central venous pressure maintenance level during laparoscopic hepatectomy negatively associated with PHLF incidence: a retrospective propensity score matching study.

Liu Z, Yang X, Yang H, Ling Z, Li Y, Wu W Surg Endosc. 2024; 39(2):1101-1113.

PMID: 39694951 DOI: 10.1007/s00464-024-11470-x.

Exploring predictive markers for liver failure post-hepatectomy in hepatocellular carcinoma patients.

Zhang S, Ma X, Zhu X, Cai N World J Gastrointest Surg. 2024; 16(5):1482-1484.

PMID: 38817295 PMC: 11135300. DOI: 10.4240/wjgs.v16.i5.1482.

Surgical approach to achieve R0 resections in primary and metastatic liver tumors: a literature review.

Vargas P, Dar N, Fernandes E, Goldaracena N J Gastrointest Oncol. 2023; 14(4):1949-1963.

PMID: 37720424 PMC: 10502561. DOI: 10.21037/jgo-22-778.

The TM6SF2 variant as a risk factor for hepatocellular carcinoma development in chronic liver disease patients.

Raia G, Abdelsameea E, Taie D, Elshaarawy O, Bayomy N, Mostafa R Clin Exp Hepatol. 2023; 8(3):211-218.

PMID: 36685261 PMC: 9850315. DOI: 10.5114/ceh.2022.119265.

Prognostic Value of CD8+ Lymphocytes in Hepatocellular Carcinoma and Perineoplastic Parenchyma Assessed by Interface Density Profiles in Liver Resection Samples.

Stulpinas R, Zilenaite-Petrulaitiene D, Rasmusson A, Gulla A, Grigonyte A, Strupas K Cancers (Basel). 2023; 15(2).

PMID: 36672317 PMC: 9857181. DOI: 10.3390/cancers15020366.

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