Outcomes of hepatectomy for hepatocellular carcinoma with bile duct tumour thrombus
| Autor: | Tiffany C.L. Wong, Chung Mau Lo, See Ching Chan, Sheung Tat Fan, Kenneth S. H. Chok, Wing Chiu Dai, Ronnie T.P. Poon, Albert C. Y. Chan, Tan To Cheung |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Oncology Thrombosis - diagnosis - etiology - surgery medicine.medical_specialty Carcinoma Hepatocellular Tumour thrombus medicine.medical_treatment Bile Ducts - surgery Gastroenterology Young Adult Liver Neoplasms - complications/diagnosis - surgery Internal medicine medicine Hepatectomy Humans neoplasms Aged Retrospective Studies Carcinoma Hepatocellular - complications/diagnosis - surgery Aged 80 and over Hepatology business.industry Bile duct Liver Neoplasms Thrombosis Original Articles Middle Aged medicine.disease Hepatectomy - methods digestive system diseases medicine.anatomical_structure Hepatocellular carcinoma Female Bile Ducts business Follow-Up Studies |
| Zdroj: | HPB. 17:401-408 |
| ISSN: | 1365-182X |
| DOI: | 10.1111/hpb.12368 |
| Popis: | This study was presented at the 11th World IHPBA Congress, 22–27 March 2014, Seoul. BACKGROUND: Hepatocellular carcinoma (HCC) with bile duct tumour thrombus (BDTT) is rare. The aim of the present study was to determine the prognosis of HCC with BDTT after a hepatectomy. METHODS: A retrospective analysis was performed on all HCC patients with BDTT having a hepatectomy from 1989 to 2012. The outcomes in these patients were compared with those in the control patients matched on a 1:6 ratio. RESULTS: Thirty-seven HCC patients with BDTT having a hepatectomy (the BDTT group) were compared with 222 control patients. Patients in the BDTT group had poorer liver function (43.2% had Child-Pugh B disease). More patients in this group had a major hepatectomy (91.9% versus 27.5%, P = 0.001), portal vein resection (10.8% versus 1.4%, P = 0.006), en-bloc resection with adjacent structures (16.2% versus 5.4%, P = 0.041), hepaticojejunostomy (75.7% versus 1.6%, P < 0.001) and complications (51.4% versus 31.1%, P = 0.016). The two groups had similar hospital mortality (2.7% versus 5.0%, P = 0.856), 5-year overall survival (38.5% versus 34.6%, P = 0.59) and 5-year disease-free survival (21.1% versus 20.8%, P = 0.81). Multivariate analysis showed that lymphovascular permeation, tumour size and post-operative complication were significant predictors for worse survival whereas BDTT was not. DISCUSSION: A major hepatectomy, extrahepatic biliary resection and hepaticojejunostomy should be the standard for HCC with BDTT, and long-term survival is possible after radical surgery. © 2014 International Hepato-Pancreato-Biliary Association. link_to_OA_fulltext |
| Databáze: | OpenAIRE |
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