BACKGROUND/AIMS: To determine resectability rates in patients with hepatocellular carcinoma (HCC) evaluated for surgical therapy. Liver resection constitutes a potentially curative treatment for HCC. However, because of the co-existing cirrhosis or the late diagnosis, only a percentage of the patients evaluated can undergo surgery. METHODOLOGY: We evaluated 333 patients with HCC admitted to our center with the intent to treat by means of tumor resection during a 6-year time period. RESULTS: Surgical resection with curative intent was undertaken in 116 patients (35%). In our series, resectability rates were significantly higher in patients with solitary HCCs (p<0.001), unilobar tumor distribution (p=0.03), and no cirrhosis (p <0.001). Transarterial chemoembolization (TACE) was the most frequent approach for nonresectable cases (18% of patients). A systematic literature review was performed in order to estimate resectability rates at other hepatobiliary centers offering multimodal treatment approaches to HCC. Results showed an overall resectability rate of 30%, with 1808 resections reported in 6108 cases. Resectability rates were significantly higher in Japanese and Eastern series when compared to American and Western studies respectively (p<0.001). CONCLUSIONS: Treatment strategies for HCC require a multidisciplinary comprehensive approach encompassing surgeons, hepatologists, radiologists, and oncologists. Surgical resection was possible in only 35% and 30% of patients with HCC evaluated for surgical therapy in our series and in the world literature, respectively. TACE was the primary treatment modality for non-resectable cases. A "no therapy" option was chosen in 21% of cases worldwide.
BACKGROUND/AIMS: To determine resectability rates in patients with hepatocellular carcinoma (HCC) evaluated for surgical therapy. Liver resection constitutes a potentially curative treatment for HCC. However, because of the co-existing cirrhosis or the late diagnosis, only a percentage of the patients evaluated can undergo surgery. METHODOLOGY: We evaluated 333 patients with HCC admitted to our center with the intent to treat by means of tumor resection during a 6-year time period. RESULTS: Surgical resection with curative intent was undertaken in 116 patients (35%). In our series, resectability rates were significantly higher in patients with solitary HCCs (p<0.001), unilobar tumor distribution (p=0.03), and no cirrhosis (p <0.001). Transarterial chemoembolization (TACE) was the most frequent approach for nonresectable cases (18% of patients). A systematic literature review was performed in order to estimate resectability rates at other hepatobiliary centers offering multimodal treatment approaches to HCC. Results showed an overall resectability rate of 30%, with 1808 resections reported in 6108 cases. Resectability rates were significantly higher in Japanese and Eastern series when compared to American and Western studies respectively (p<0.001). CONCLUSIONS: Treatment strategies for HCC require a multidisciplinary comprehensive approach encompassing surgeons, hepatologists, radiologists, and oncologists. Surgical resection was possible in only 35% and 30% of patients with HCC evaluated for surgical therapy in our series and in the world literature, respectively. TACE was the primary treatment modality for non-resectable cases. A "no therapy" option was chosen in 21% of cases worldwide.
Authors: Georgios C Sotiropoulos; Nina Drühe; George Sgourakis; Ernesto P Molmenti; Susanne Beckebaum; Hideo A Baba; Gerald Antoch; Philip Hilgard; Arnold Radtke; Fuat H Saner; Silvio Nadalin; Andreas Paul; Massimo Malagó; Christoph E Broelsch; Hauke Lang Journal: Dig Dis Sci Date: 2008-12-05 Impact factor: 3.199
Authors: Ryan T Groeschl; Ray K Wong; Edward J Quebbeman; Susan Tsai; Kiran K Turaga; Sam G Pappas; Kathleen K Christians; Eric J Hohenwalter; Sean M Tutton; William S Rilling; T Clark Gamblin Journal: HPB (Oxford) Date: 2012-10-11 Impact factor: 3.647