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Khirurgiia (Mosk) ; (10): 13-9, 2011.
Article in Russian | MEDLINE | ID: mdl-22334898

ABSTRACT

154 radical liver resections were performed on the reason of the hepatocellular cancer, of them 33% in patients with liver cirrhosis. Liver function was assessed using the Child--Pugh score. Liver cirrhosis and extensive liver resections proved to be the independent complication and lethality risk factors. The extensive liver resections were performed in 70%. The postoperative morbidity rate was 44.8%, the lethality was 5.8%. The concomitant liver cirrhosis reliably worsens postoperative complications (p = 0.001) and lethality (p = 0.0001) rates. The long-term treatment results were analyzed. Thus, liver resection proved to be an appropriate treatment for patients with hepatocellular cancer and liver cirrhosis Child--Pugh stage A, but a thorough patient selection is recommended. Liver resection is contraindicated by liver cirrhosis Child--Pugh stage B. The orthotopic liver transplantation is recommended in such cases, considering that Milan criteria are observed. The rest cases should consider the possibilities of radiofrequency ablation, transarterial chemoembolization, chemotherapy.


Subject(s)
Carcinoma, Hepatocellular , Catheter Ablation/methods , Chemoembolization, Therapeutic/methods , Drug Therapy/methods , Hepatectomy/methods , Liver Cirrhosis , Adolescent , Adult , Aged , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/therapy , Combined Modality Therapy , Contraindications , Female , Hepatectomy/adverse effects , Humans , Liver/pathology , Liver/physiopathology , Liver/surgery , Liver Cirrhosis/complications , Liver Cirrhosis/mortality , Liver Function Tests/methods , Liver Neoplasms/complications , Liver Neoplasms/mortality , Liver Neoplasms/pathology , Liver Neoplasms/therapy , Liver Transplantation , Male , Middle Aged , Patient Selection , Postoperative Complications/prevention & control , Risk Factors , Severity of Illness Index , Survival Analysis , Treatment Outcome
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