Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis
Autor: | Omar Elshaarawy, Esam Elshimi, Hazem M Zakaria, Talaat Zakareya, Aya Aman, Asmaa Gomaa, Eman Abdelsameea |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Cirrhosis business.industry Hepatocellular carcinoma Gastroenterology Scores medicine.disease Resection digestive system diseases 03 medical and health sciences 0302 clinical medicine Oncology Liver Retrospective Study 030220 oncology & carcinogenesis Internal medicine Medicine 030211 gastroenterology & hepatology In patient business |
Zdroj: | World Journal of Gastrointestinal Oncology |
ISSN: | 1948-5204 |
Popis: | BACKGROUND Given the poor synthetic function of cirrhotic liver, successful resection for patients with hepatocellular carcinoma (HCC) necessitates the ability to achieve resections with tumor free margins. AIM To validate post hepatectomy liver failure score (PHLF), compare it to other established systems and to stratify risks in patients with cirrhosis who underwent curative liver resection for HCC. METHODS Between December 2010 and January 2017, 120 patients underwent curative resection for HCC in patients with cirrhosis were included, the pre-operative, operative and post-operative factors were recorded to stratify patients' risks of decompensation, survival, and PHLF. RESULTS The preoperative model for end-stage liver disease (MELD) score [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (OR = 2.5, 95%CI: 1.5-4.2, P = 0.001) were significant independent predictors of hepatic decompensation after resection. While the preoperative MELD score [hazard ratio (HR) = 1.37, 95%CI: 1.16-1.62, P < 0.001] and different grades of PHLF (grade A: HR = 2.33, 95%CI: 0.59-9.24; Grade B: HR = 3.15, 95%CI: 1.11-8.95; Grade C: HR = 373.41, 95%CI: 66.23-2105.43; P < 0.001) and HCC recurrence (HR = 11.67, 95%CI: 4.19-32.52, P < 0.001) were significant independent predictors for survival. CONCLUSION Preoperative MELD score and tumor diameter can independently predict hepatic decompensation. While, preoperative MELD score, different grades of PHLF and HCC recurrence can precisely predict survival. |
Databáze: | OpenAIRE |
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