PURPOSE: The optimum strategy, hepatic resection (HR) or liver transplantation (LT), for treatment of early hepatocellular carcinoma (HCC) associated with liver diseases of Child-Pugh A is far from established. The aim of this study was to compare and determine which strategy is optimal for HCC fulfilling the Milan criteria. METHODS: Consecutive data were collected in 1,018 HCC patients treated with HR and 89 HCC patients listed for LT (1 drop out for HCC progression) between January of 2003 and December of 2007. RESULTS: The independent prognostic factors identified by multivariate analysis were tumor size-plus-number, microscopic venous invasion, and operation type (LT or HR). When tumor size-plus-number was < or =4 or microscopic venous invasion was absent, there was no significant difference in overall survival (OS) between the LT and HR group. When tumor size-plus-number was >4 or microscopic venous invasion was present, OS was higher in the LT group. CONCLUSIONS: Since the pathological microscopic venous invasion was not easily available before operation which is limitation for widespread clinical use, thus in practice, we concluded that, for early HCC associated with Child-Pugh A cirrhosis, when tumor size-plus-number is >4, LT provides the best cure; when it is < or =4, HR remains the initial treatment of choice.
PURPOSE: The optimum strategy, hepatic resection (HR) or liver transplantation (LT), for treatment of early hepatocellular carcinoma (HCC) associated with liver diseases of Child-Pugh A is far from established. The aim of this study was to compare and determine which strategy is optimal for HCC fulfilling the Milan criteria. METHODS: Consecutive data were collected in 1,018 HCC patients treated with HR and 89 HCC patients listed for LT (1 drop out for HCC progression) between January of 2003 and December of 2007. RESULTS: The independent prognostic factors identified by multivariate analysis were tumor size-plus-number, microscopic venous invasion, and operation type (LT or HR). When tumor size-plus-number was < or =4 or microscopic venous invasion was absent, there was no significant difference in overall survival (OS) between the LT and HR group. When tumor size-plus-number was >4 or microscopic venous invasion was present, OS was higher in the LT group. CONCLUSIONS: Since the pathological microscopic venous invasion was not easily available before operation which is limitation for widespread clinical use, thus in practice, we concluded that, for early HCC associated with Child-Pugh A cirrhosis, when tumor size-plus-number is >4, LT provides the best cure; when it is < or =4, HR remains the initial treatment of choice.
Authors: Georgios C Sotiropoulos; Andreas Paul; Ernesto Molmenti; Hauke Lang; Andrea Frilling; Bogdan P Napieralski; Silvio Nadalin; Jürgen Treckmann; Eirini I Brokalaki; Till Gerling; Christoph E Broelsch; Massimo Malagó Journal: Transplantation Date: 2005-10-15 Impact factor: 4.939
Authors: Timothy M Pawlik; Keith A Delman; Jean-Nicolas Vauthey; David M Nagorney; Irene Oi-Lin Ng; Iwao Ikai; Yoshio Yamaoka; Jacques Belghiti; Gregory Y Lauwers; Ronnie T Poon; Eddie K Abdalla Journal: Liver Transpl Date: 2005-09 Impact factor: 5.799
Authors: C Benckert; S Jonas; A Thelen; A Spinelli; G Schumacher; M Heise; J Langrehr; P Neuhaus Journal: Transplant Proc Date: 2005-05 Impact factor: 1.066
Authors: Jin Hean Koh; Darren Jun Hao Tan; Yuki Ong; Wen Hui Lim; Cheng Han Ng; Phoebe Wen Lin Tay; Jie Ning Yong; Mark D Muthiah; Eunice X Tan; Ning Qi Pang; Beom Kyung Kim; Nicholas Syn; Alfred Kow; Brian K P Goh; Daniel Q Huang Journal: Hepatobiliary Surg Nutr Date: 2022-02 Impact factor: 8.265