Single Center Experience (Ten Years) with Surgical Resection for Treating Hepatocellular Carcinoma: Strategies for improving the long-term survival after resection
Korean Journal of Hepato-Biliary-Pancreatic Surgery
;
: 245-253, 2008.
Artigo
em Coreano
| WPRIM
| ID: wpr-98947
ABSTRACT
PURPOSE:
Although surgical resection is the most effective treatment for hepatocellular carcinoma (HCC), high recurrence after resection is a major challenging problem. We attempted to determine the optimal strategies for improving the long-term surgical outcome through the review of our 10 years' experience with surgically treating HCC.METHODS:
We retrospectively reviewed 497 patients who received curative resection at the Yonsei University Health System from January 1996 to August 2006.RESULTS:
The 5 year disease-free rate and the overall survival rate after curative resection were 45.0% and 63.9%, respectively. Of the 497 patients, 491 (98.8%) were Child-Pugh A and 107 (56.3%) were diagnosed with liver cirrhosis. The postoperative complication and mortality rates were 28.6% and 1.8%, respectively. Of the 243 recurrent patients, 184 (75.7%) were diagnosed with intrahepatic recurrence alone. Of these intrahepatic recurrent patients, 169 (91.9%) received active treatment, including transplantation (n=7), re-resection (n=12), local ablation therapy (n=18) and transarterial chemoembolization (n=132). Multivariate analysis revealed that perioperative transfusion, a satellite nodule, the pathologic TNM stage, the Edmondsons-Steiner grade, the serum alkaline phosphatase (ALP) and aspartate aminotransferase levels and cirrhosis were associated with disease free survival, and perioperative transfusion, a satellite nodule, macroscopic vascular invasion, the Edmondsons-Steiner grade, the ALP and serum albumin levels and the platelet count were related with overall survival after resection.CONCLUSIONS:
The long-term surgical outcome of HCC can be further improved by proper patient selection, delicately performed surgery and administering postoperative adjuvant therapy for patients with a high risk of recurrence. Early diagnosis and aggressive treatment are needed to treat the recurrence
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Contagem de Plaquetas
/
Complicações Pós-Operatórias
/
Aspartato Aminotransferases
/
Recidiva
/
Fibrose
/
Albumina Sérica
/
Análise Multivariada
/
Taxa de Sobrevida
/
Estudos Retrospectivos
/
Carcinoma Hepatocelular
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo de rastreamento
Limite:
Humanos
Idioma:
Coreano
Revista:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Ano de publicação:
2008
Tipo de documento:
Artigo
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