Surgical management of hepatic malignancy Journal Article


Authors: Kooby, D. A.; Jarnagin, W. R.
Article Title: Surgical management of hepatic malignancy
Abstract: Over the past twenty-five years, hepatic resection has evolved from a high risk, resource-intensive procedure with limited application to a safe and commonly performed operation with broad indications. This period has seen dramatic improvements in perioperative outcome, including reductions in mortality, blood loss, transfusion rates, and hospital stay. These improved perioperative results are largely responsible for the emergence of hepatic resection as a viable and effective treatment option for selected patients with 1° and 2° hepatobiliary malignancy. Continued advances in imaging technology, along with a heightened awareness of the clinical and tumor-related variables that dictate outcome, have allowed better preoperative assessment of disease extent and improved patient selection. Advances in other areas. such as minimally invasive and ablative techniques, have increased the treatment options and have had some impact on the approach to patients with malignant hepatobiliary disease; however, resection remains the most effective therapy. Although the long term results after resection are better than with other modalities, recurrence rates remain high, and further improvements in survival will require more effective systemic agents. As better adjuvant and neo-adjuvant therapies emerge, the results of resection are likely to improve and the indications for its application perhaps will extend to patients currently considered to have unresectable disease.
Keywords: treatment outcome; survival analysis; survival rate; cancer recurrence; liver cell carcinoma; patient selection; carcinoma, hepatocellular; liver neoplasms; cancer adjuvant therapy; neoadjuvant therapy; preoperative evaluation; treatment indication; bleeding; colorectal neoplasms; length of stay; liver; colorectal tumor; liver tumor; carcinoma; blood transfusion; liver resection; surgical mortality; short survey; minimally invasive surgery; hepatectomy; surgical procedures, minimally invasive; liver cancer; safety; bile duct cancer; hepatocellular; colorectal neoplasm; humans; prognosis; human; priority journal; liver neoplasm
Journal Title: Cancer Investigation
Volume: 22
Issue: 2
ISSN: 0735-7907
Publisher: Informa Healthcare  
Date Published: 2004-01-01
Start Page: 283
End Page: 303
Language: English
DOI: 10.1081/cnv-120030217
PUBMED: 15199611
PROVIDER: scopus
DOI/URL:
Notes: Cited By (since 1996):21 -- Export Date: 16 June 2014 -- CODEN: CINVD -- Source: Scopus
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  1. David Kooby
    25 Kooby
  2. William R Jarnagin
    903 Jarnagin