Surgery for hepatocellular carcinoma presenting with variceal bleeding: The eastern experience

Autor: Meng-Chao Wu, Yi-Nan Shen, Jun-Hua Lu, Wan Yee Lau, Zhouchong Wang, Guang-Shun Yang, Kutaiba Alshebeeb, Tian Yang, Feng Shen, Haiguan He, Jianyong Yuan, Jin Zhang
Rok vydání: 2015
Předmět:
Zdroj: Journal of Surgical Oncology. 113:165-174
ISSN: 0022-4790
DOI: 10.1002/jso.24106
Popis: Background Variceal bleeding can be the first manifestation of patients with newly diagnosed hepatocellular carcinoma (HCC), and effective treatments deserve to be explored for these patients. Methods A prospectively collected database of HCC patients undergoing hepatectomy identified 75 patients who presented with variceal bleeding. Among them, 31 patients underwent concomitant Hassab's operation. The clinical variables and outcomes were compared between the Hassab and non-Hassab groups. Results The postoperative morbidity and 90-days mortality were 44.0% and 6.7% respectively. Variceal re-bleeding and tumor recurrence occurred in 28.8% and 52.1% of surviving patients after surgery, and the 1-, 3-, and 5-year overall survival rates were 87.7, 66.8, and 50.3%. There were no significant differences in morbidity, mortality and postoperative recurrence between the Hassab and non-Hassab groups. However, patients in the Hassab group had significantly higher 1-, 3-, and 5-year overall survival rates (P = 0.038), and significantly lower rate of re-bleeding (13.3% vs. 39.5%, P = 0.014) than those in the non-Hassab group. On multivariable analysis, concomitant Hassab's operation was independently predicted longer overall survival. Conclusion Liver resection could safely be performed in selected patients with HCC who presented with variceal bleeding, and concomitant Hassab's operation may improve long-term prognosis for these patients. J. Surg. Oncol. © 2015 Wiley Periodicals, Inc.
Databáze: OpenAIRE
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