Prognostic Factors and Longterm Survival after Hepatic Resection for Hepatocellular Carcinoma Originating from Noncirrhotic Liver - 21/08/11
⁎, Jean Frédéric Blanc, MD, PhD †, Steeve Nobili, MD , Antonio Sa Cunha, MD , Brigitte le Bail, MD, PhD ‡, Paulette Bioulac-Sage, MD ‡, Charles Balabaud, MD †, Maylis Capdepont , Jean Saric, MD Department of Surgery, Saint-Andre Hospital, Bordeaux, France. Correspondence address: Christophe Laurent, MD, Service de Chirurgie Digestive, Hôpital Saint-André, 33075 Bordeaux, France.Résumé |
Background |
The incidence of hepatocellular carcinoma (HCC) in cirrhotic and noncirrhotic liver is increasing in the world, probably because of the high prevalence of infections by hepatitis B and C viruses. Despite numerous publications on hepatic resection, prognostic factors for intrahepatic recurrence and survival are not well known for patients with HCC without cirrhosis.
Study design |
One hundred eight consecutive patients with HCC in noncirrhotic liver have been treated by hepatic resection in the past 18 years in our center. Clinical, biologic, and histopathologic parameters of these patients were collected. Risk factors for intrahepatic recurrence and prognostic factors for survival were evaluated by univariate and multivariate analyses.
Results |
Postoperative morbidity and mortality rates were 23% and 6.5%, respectively. The 3- and 5-year disease-free and overall survival rates were 55% and 43%, and 43% and 29%, respectively. Blood transfusion, absence of tumor capsule, and daughter nodules were independently associated with overall survival. But the only risk factors for recurrence were blood transfusion, absence of tumor capsule, daughter nodules, and margin resection < 10 mm.
Conclusions |
In the treatment of HCC without cirrhosis, hepatectomy remains a safe and legitimate treatment, but longterm results are impaired by a high rate of early recurrence likely related to metastatic dissemination. Only histopathologic factors related to the tumor are predictive of recurrence and overall survival.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : AFP, HBs, HCC, HCV
Plan
| Competing Interests Declared: None. |
Vol 201 - N° 5
P. 656-662 - novembre 2005 Retour au numéro
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