BACKGROUND: The appropriate surgical approach for hepatocellular carcinoma (HCC) patients of Child-Pugh class B is unclear. The aim of this study was to clarify the prognostic factors after hepatectomy in Child-Pugh class B patients and to delineate the selection criteria for hepatectomy. METHODS: One hundred fifty patients of Child-Pugh class B who underwent hepatectomy were enrolled in this retrospective study (Hx group). Univariate and multivariate analyses were performed to identify prognostic factors. The prognosis was compared with that of 23 patients of Child-Pugh class B who underwent liver transplantation (LT group). RESULTS: The overall survival rate of the Hx group was significantly worse than that of the LT group (5-year survival: 36.0 vs. 78.3%, p = 0.001). In multivariate analyses, diabetes mellitus (p = 0.011), preoperative total bilirubin level ≥ 1.5 mg/dl (p = 0.038), and Child-Pugh score of 8 or 9 (p = 0.038) were independent prognostic factors. Although the overall 5-year survival rate of patients with none of the three adverse prognostic factors was only 50.3%, that of patients with one or more adverse prognostic factors was only 27.2% (p = 0.001). CONCLUSIONS: Hepatectomy may be the optimal initial treatment for HCC patients classified as Child-Pugh class B and without any adverse prognostic factors.
BACKGROUND: The appropriate surgical approach for hepatocellular carcinoma (HCC) patients of Child-Pugh class B is unclear. The aim of this study was to clarify the prognostic factors after hepatectomy in Child-Pugh class B patients and to delineate the selection criteria for hepatectomy. METHODS: One hundred fifty patients of Child-Pugh class B who underwent hepatectomy were enrolled in this retrospective study (Hx group). Univariate and multivariate analyses were performed to identify prognostic factors. The prognosis was compared with that of 23 patients of Child-Pugh class B who underwent liver transplantation (LT group). RESULTS: The overall survival rate of the Hx group was significantly worse than that of the LT group (5-year survival: 36.0 vs. 78.3%, p = 0.001). In multivariate analyses, diabetes mellitus (p = 0.011), preoperative total bilirubin level ≥ 1.5 mg/dl (p = 0.038), and Child-Pugh score of 8 or 9 (p = 0.038) were independent prognostic factors. Although the overall 5-year survival rate of patients with none of the three adverse prognostic factors was only 50.3%, that of patients with one or more adverse prognostic factors was only 27.2% (p = 0.001). CONCLUSIONS: Hepatectomy may be the optimal initial treatment for HCCpatients classified as Child-Pugh class B and without any adverse prognostic factors.
Authors: S Arii; Y Yamaoka; S Futagawa; K Inoue; K Kobayashi; M Kojiro; M Makuuchi; Y Nakamura; K Okita; R Yamada Journal: Hepatology Date: 2000-12 Impact factor: 17.425
Authors: Y Ikeda; M Shimada; H Hasegawa; T Gion; K Kajiyama; K Shirabe; K Yanaga; K Takenaka; K Sugimachi Journal: Hepatology Date: 1998-06 Impact factor: 17.425
Authors: Danijel A Galun; Predrag Bulajic; Marinko Zuvela; Dragan Basaric; Tatjana Ille; Miroslav N Milicevic Journal: World J Surg Date: 2012-07 Impact factor: 3.352
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