Improving Survival Results After Resection of Hepatocellular Carcinoma: A Prospective Study of 377 Patients Over 10 Years
By R. Poon, S. Fan, C. Lo, I. Ng, Chi-leung Liu, C. Lam, J. Wong. Annals of Surgery, 2001
595 citations recorded by the source corpus.
ObjectiveTo investigate whether the survival results after resection of hepatocellular carcinoma (HCC) have improved within the past decade by an analysis of a prospective cohort of patients over a 10-year period. Summary Background DataThe surgical death rate after resection of HCC has greatly improved in recent years, but the long-term prognosis remains unsatisfactory. It remains unknown whether the survival results after resection of HCC have improved within the past decade. MethodsThe clinicopathologic and follow-up data of 377 patients who underwent curative resection of HCC between January 1989 and January 1999 were prospectively collected. These patients were categorized according to two time periods: before 1994 (group 1, n = 136) and after 1994 (group 2, n = 241). The two groups were compared for clinicopathologic data and survival results. The prognostic factors for disease-free survival were further analyzed to identify the factors that might have led to improved survival outcomes. ResultsThe overall and disease-free survival results were significantly better in group 2 compared with group 1. Patients in group 2 had significantly higher proportions of subclinical presentation, small tumors, and tumors of early pTNM stage. There were also significantly lower frequencies of histologic margin involvement, less intraoperative blood loss, and a lower transfusion rate in group 2. By multivariate analysis, early pTNM stage, subclinical HCC, and no perioperative transfusion were independent favorable prognostic factors for disease-free survival. ConclusionsSignificant improvement of overall and disease-free survival results after resection of HCC has been achieved within the past decade as a result of advances in the diagnosis and surgical management of HCC. Earlier diagnosis of HCC by better imaging modalities, increased detection of subclinical HCC by screening of high-risk patients, and a reduced perioperative transfusion rate were identified as the major contributory factors for the improved outcomes.
Subfields: Hepatology, Oncology, Surgery
View Paper: https://www.semanticscholar.org/paper/8a8f690dcfdf74693a6a1923f76905e4f80cb44f
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Citations in the corpus
- Improving Perioperative Outcome Expands the Role of Hepatectomy in Management of Benign and Malignant Hepatobiliary Diseases: Analysis of 1222 Consecutive Patients From a Prospective Database (2004, result): “Our aggressive approach was partly driven by the improving survival results that we have observed in hepatic resection for HCC, even for large HCC that required extended hepatectomy.(22,32) Excluding living donors with normal liver undergoing donor hepatectomy for liver transplantation, the proporti”
- Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma (2010, background): “The 5-year survival after resection of HCC is 35–50% in recent large cohort studies [257–259].”
- One thousand fifty-six hepatectomies without mortality in 8 years. (2003, unknown): “Blood loss, mL 635 (15-8200) 578 (0-6650) 913 (80-3136) 459 (35-2000) 580 (17-2100)”