BACKGROUND: The aim of this study was to clarify the long-term surgical outcomes of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) and to identify a therapeutic strategy for this condition. METHODS: Forty-four patients who underwent hepatectomy for HCC with BDTT or direct invasion involving the first branches of the bile duct or common hepatic duct were enrolled in this study. The overall survival time and time to recurrence were analyzed. RESULTS: The median survival time and the 5-year survival rate were 23.7 months and 31.0%, respectively. Child-Pugh classification B [hazard ratio (HR) 4.92; 95% confidence interval (CI) 1.97-11.65], major vascular invasion (MVI; HR 2.79; 95% CI 1.14-6.87), and serosal invasion (HR 2.71; 95% CI 1.19-6.02) were independent prognostic factors for overall survival. The median survival times were 12.3 and 72.3 months for the patients with and without MVI, respectively. Among the 41 patients who underwent macroscopic curative resection, the median time to recurrence and the 5-year recurrence rate were 8.6 months and 85.6%, respectively. MVI was the only independent prognostic factor for recurrence (HR 3.31; 95% CI 1.55-7.05). The median times to recurrence were 3.7 and 11.6 months for the patients with and without MVI, respectively. CONCLUSIONS: Concomitant MVI was a strong prognostic factor in the setting of HCC with BDTT. Extended hepatectomy provided a good prognosis for the patients with BDTT alone without MVI.
BACKGROUND: The aim of this study was to clarify the long-term surgical outcomes of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) and to identify a therapeutic strategy for this condition. METHODS: Forty-four patients who underwent hepatectomy for HCC with BDTT or direct invasion involving the first branches of the bile duct or common hepatic duct were enrolled in this study. The overall survival time and time to recurrence were analyzed. RESULTS: The median survival time and the 5-year survival rate were 23.7 months and 31.0%, respectively. Child-Pugh classification B [hazard ratio (HR) 4.92; 95% confidence interval (CI) 1.97-11.65], major vascular invasion (MVI; HR 2.79; 95% CI 1.14-6.87), and serosal invasion (HR 2.71; 95% CI 1.19-6.02) were independent prognostic factors for overall survival. The median survival times were 12.3 and 72.3 months for the patients with and without MVI, respectively. Among the 41 patients who underwent macroscopic curative resection, the median time to recurrence and the 5-year recurrence rate were 8.6 months and 85.6%, respectively. MVI was the only independent prognostic factor for recurrence (HR 3.31; 95% CI 1.55-7.05). The median times to recurrence were 3.7 and 11.6 months for the patients with and without MVI, respectively. CONCLUSIONS: Concomitant MVI was a strong prognostic factor in the setting of HCC with BDTT. Extended hepatectomy provided a good prognosis for the patients with BDTT alone without MVI.
Authors: Y Yamamoto; I Ikai; M Kume; Y Sakai; A Yamauchi; H Shinohara; T Morimoto; Y Shimahara; M Yamamoto; Y Yamaoka Journal: World J Surg Date: 1999-10 Impact factor: 3.352
Authors: Nuh N Rahbari; O James Garden; Robert Padbury; Mark Brooke-Smith; Michael Crawford; Rene Adam; Moritz Koch; Masatoshi Makuuchi; Ronald P Dematteo; Christopher Christophi; Simon Banting; Val Usatoff; Masato Nagino; Guy Maddern; Thomas J Hugh; Jean-Nicolas Vauthey; Paul Greig; Myrddin Rees; Yukihiro Yokoyama; Sheung Tat Fan; Yuji Nimura; Joan Figueras; Lorenzo Capussotti; Markus W Büchler; Jürgen Weitz Journal: Surgery Date: 2011-01-14 Impact factor: 3.982
Authors: S Satoh; I Ikai; G Honda; H Okabe; O Takeyama; Y Yamamoto; N Yamamoto; Y Iimuro; Y Shimahara; Y Yamaoka Journal: Surgery Date: 2000-11 Impact factor: 3.982
Authors: Jihyun An; Kwang Sun Lee; Kang Mo Kim; Do Hyun Park; Sang Soo Lee; Danbi Lee; Ju Hyun Shim; Young-Suk Lim; Han Chu Lee; Young-Hwa Chung; Yung Sang Lee Journal: Clin Mol Hepatol Date: 2017-05-16