Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma Journal Article
| Authors: | Vauthey, J. N.; Klimstra, D.; Franceschi, D.; Tao, Y.; Fortner, J.; Blumgart, L.; Brennan, M. |
| Article Title: | Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma |
| Abstract: | Background: Experience with hepatocellular carcinoma (HCC) is limited in the West and factors affecting outcome after resection are not clearly defined. Methods: Between 1970 and 1992, 106 patients (including 74 Caucasians, 31 Orientals, and 1 black) underwent hepatic resection for HCC at Memorial Sloan-Kettering Cancer Center. Clinical and histopathologic factors of outcome were analyzed. Results: Cirrhosis was present in 33% and 95% were Child-Pugh A. Operative mortality was 6%, 14% in cirrhotics versus 1% in noncirrhotics (P = 0.013). Orientals had a higher prevalence of cirrhosis (68% versus 19%) (P <0.0001) and smaller tumors (mean 8.7 cm versus 11.0 cm) (P = 0.028) compared to Caucasians. Overall survival was 41% and 32% at 5 and 10 years, respectively. By univariate analysis, survival was greater in association with the following: absence of vascular invasion (69% versus 28%, P = 0.002); absence of symptoms (66% versus 38%, P = 0.014); solitary tumor (53% versus 28%, P = 0.014); negative margins (46% versus 21%, P = 0.022); small tumor (≤5 cm) (75% versus 36%, P = 0.027); and presence of tumor capsule (69% versus 35%, P = 0.047). Ethnic origin, cirrhosis, necrosis and grade did not affect survival. By multivariate analysis, only vascular invasion predicted outcome (P = 0.0025, risk ratio 2.9). Conclusions: One third of patients resected for HCC can be expected to survive long-term. Except for a higher incidence of cirrhosis in Orientals, no major histopathologic or prognostic differences were noted between Orientals and Caucasians undergoing resection. Early cirrhosis (Child-Pugh A) did not adversely affect survival. Vascular invasion predicted long-term outcome. © 1995. |
| Keywords: | survival; adolescent; adult; controlled study; human tissue; treatment outcome; aged; aged, 80 and over; survival rate; retrospective studies; major clinical study; hepatitis b; liver cell carcinoma; liver cirrhosis; carcinoma, hepatocellular; liver neoplasms; conference paper; tumor volume; incidence; risk factors; prediction; postoperative complication; cancer invasion; long term care; blood vessel; liver resection; hepatectomy; tumor growth; ethnic difference; middle age; liver necrosis; human; male; female; priority journal; support, non-u.s. gov't; mongoloid race; caucasoid race |
| Journal Title: | American Journal of Surgery |
| Volume: | 169 |
| Issue: | 1 |
| ISSN: | 0002-9610 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1995-01-01 |
| Start Page: | 28 |
| End Page: | 35 |
| Language: | English |
| DOI: | 10.1016/s0002-9610(99)80106-8 |
| PUBMED: | 7817995 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 28 August 2018 -- Source: Scopus |
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