BACKGROUND AND OBJECTIVES: Fibrolamellar carcinoma (FLC) presents in young, otherwise-healthy individuals. This study examined recurrence and survival characteristics after surgical resection for FLC by utilizing an international multi-institutional database. METHODS: Consecutive patients undergoing hepatectomy for FLC from six institutions (1993-2010) were reviewed retrospectively. Survival was studied with life tables and Cox regression models. RESULTS: Thirty-five patients (13 female, 37%) were included (median age: 32 years). R0 resection was achieved in all curative-intent operations (n = 30), and palliative operations were performed for five patients. Crude 30-day morbidity and mortality rates were 22% and 3%, respectively. For curative-intent surgery, overall and recurrence-free survivals at 5 years were 62% and 45%, respectively. In patients who achieved a 4-year disease-free interval after surgery, none subsequently developed recurrence. In multivariate models, presence of extrahepatic disease was the only factor that independently predicted overall (hazard ratio [HR]: 5.58, 95% confidence interval [CI]: 1.38-22.55, P = 0.016) and recurrence-free survival (HR: 5.64, 95% CI: 1.48-21.49, P = 0.011). CONCLUSIONS: Patients with surgically amenable FLC had encouraging long-term survival. Recurrence-free survival to 4 years suggested possible freedom from disease thereafter. Recurrent resectable disease was associated with an excellent prognosis, and repeat surgery should be strongly considered.
BACKGROUND AND OBJECTIVES:Fibrolamellar carcinoma (FLC) presents in young, otherwise-healthy individuals. This study examined recurrence and survival characteristics after surgical resection for FLC by utilizing an international multi-institutional database. METHODS: Consecutive patients undergoing hepatectomy for FLC from six institutions (1993-2010) were reviewed retrospectively. Survival was studied with life tables and Cox regression models. RESULTS: Thirty-five patients (13 female, 37%) were included (median age: 32 years). R0 resection was achieved in all curative-intent operations (n = 30), and palliative operations were performed for five patients. Crude 30-day morbidity and mortality rates were 22% and 3%, respectively. For curative-intent surgery, overall and recurrence-free survivals at 5 years were 62% and 45%, respectively. In patients who achieved a 4-year disease-free interval after surgery, none subsequently developed recurrence. In multivariate models, presence of extrahepatic disease was the only factor that independently predicted overall (hazard ratio [HR]: 5.58, 95% confidence interval [CI]: 1.38-22.55, P = 0.016) and recurrence-free survival (HR: 5.64, 95% CI: 1.48-21.49, P = 0.011). CONCLUSIONS:Patients with surgically amenable FLC had encouraging long-term survival. Recurrence-free survival to 4 years suggested possible freedom from disease thereafter. Recurrent resectable disease was associated with an excellent prognosis, and repeat surgery should be strongly considered.
Authors: William J Hammond; Gadi Lalazar; James A Saltsman; Benjamin A Farber; Enrico Danzer; Tshering C Sherpa; Charles D Banda; Jeffrey R Andolina; Sasan Karimi; Cameron W Brennan; Michael S Torbenson; Michael P La Quaglia; Sanford M Simon Journal: Pediatr Blood Cancer Date: 2017-12-29 Impact factor: 3.167
Authors: Scott S Short; Zachary J Kastenberg; Guo Wei; Alex Bondoc; Roshni Dasgupta; Greg M Tiao; Erin Watters; Todd E Heaton; Dimitra Lotakis; Michael P La Quaglia; Andrew J Murphy; Andrew M Davidoff; Sara A Mansfield; Max R Langham; Timothy B Lautz; Riccardo A Superina; Katherine C Ott; Marcus M Malek; Katrina M Morgan; Eugene S Kim; Abigail Zamora; Danny Lascano; Jonathan Roach; Joseph T Murphy; David H Rothstein; Sanjeev A Vasudevan; Richard Whitlock; Dave R Lal; Brian Hallis; Andreana Bütter; Reto M Baertschiger; Eveline Lapidus-Krol; Juan Putra; Elisabeth R Tracy; Jennifer H Aldrink; Jordan Apfeld; Hau D Le; Keon Y Park; Barrie S Rich; Richard D Glick; Elizabeth A Fialkowski; Alan F Utria; Rebecka L Meyers; Kimberly J Riehle Journal: Cancer Date: 2022-05-13 Impact factor: 6.921
Authors: Kelly J Lafaro; Oliver S Eng; Mustafa Raoof; Philip Ituarte; Susanne G Warner; Gagandeep Singh; Yuman Fong; Laleh G Melstrom Journal: Hepatobiliary Surg Nutr Date: 2019-08 Impact factor: 7.293
Authors: Kevin M Riggle; Rigney Turnham; John D Scott; Raymond S Yeung; Kimberly J Riehle Journal: Pediatr Blood Cancer Date: 2016-03-14 Impact factor: 3.167