Chun-Han Chen1, Tzu-Hao Huang1, Cheng-Chih Chang1, Wei-Feng Li2, Ting-Lung Lin2, Chih-Chi Wang3,4. 1. Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan. 2. Division of General Surgery, Liver Transplant Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 123 Ta-Pei Road, Niao-Song, Kaohsiung, 833, Taiwan. 3. Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan. ufel4996@ms26.hinet.net. 4. Division of General Surgery, Liver Transplant Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 123 Ta-Pei Road, Niao-Song, Kaohsiung, 833, Taiwan. ufel4996@ms26.hinet.net.
Abstract
BACKGROUND: Surgical management of centrally located hepatocellular carcinoma (CL-HCC) poses a great challenge. Major hepatectomy (MH) might compromise future remnant liver volume (FRLV), while the long-term benefits of central hepatectomy (CH) had not been well demonstrated. METHODS: Consecutive patients with early-stage CL-HCC who underwent liver resection were enrolled. Fifteen patients underwent CH, while thirty-three were subjected to MH. All relevant clinicopathological variables were analyzed. Disease-free survival (DFS) and overall survival (OS) of both groups were compared. RESULTS: There were no differences between CH and MH in terms of predisposing liver disease, tumor size, blood loss, complication rate and vascular invasion. Mean FRLV increased from 40.9 to 69.2% by using CH resection lines. The parenchymal transection time is longer in CH. There were no differences of DFS between two groups. The 5-year OS rates of CH and MH were 93.3 and 62.6%, respectively. MH was a poor prognostic factor. CONCLUSIONS: CH is a relatively time-consuming and technique-demanding procedure, but excellent long-term survival could be achieved. CH could increase liver volume preservation without compromising intra-hepatic recurrence. In an endemic area of hepatitis and cirrhosis, CH should still play an important role in surgical treatment of CL-HCC.
BACKGROUND: Surgical management of centrally located hepatocellular carcinoma (CL-HCC) poses a great challenge. Major hepatectomy (MH) might compromise future remnant liver volume (FRLV), while the long-term benefits of central hepatectomy (CH) had not been well demonstrated. METHODS: Consecutive patients with early-stage CL-HCC who underwent liver resection were enrolled. Fifteen patients underwent CH, while thirty-three were subjected to MH. All relevant clinicopathological variables were analyzed. Disease-free survival (DFS) and overall survival (OS) of both groups were compared. RESULTS: There were no differences between CH and MH in terms of predisposing liver disease, tumor size, blood loss, complication rate and vascular invasion. Mean FRLV increased from 40.9 to 69.2% by using CH resection lines. The parenchymal transection time is longer in CH. There were no differences of DFS between two groups. The 5-year OS rates of CH and MH were 93.3 and 62.6%, respectively. MH was a poor prognostic factor. CONCLUSIONS: CH is a relatively time-consuming and technique-demanding procedure, but excellent long-term survival could be achieved. CH could increase liver volume preservation without compromising intra-hepatic recurrence. In an endemic area of hepatitis and cirrhosis, CH should still play an important role in surgical treatment of CL-HCC.
Authors: Ronnie Tung Ping Poon; Sheung Tat Fan; Chung Mau Lo; Chi Leung Liu; Chi Ming Lam; Wai Kei Yuen; Chun Yeung; John Wong Journal: Ann Surg Date: 2002-11 Impact factor: 12.969
Authors: Jeff Siu-Wang Wong; Grace Lai-Hung Wong; Anthony Wing-Hung Chan; Vincent Wai-Sun Wong; Yue-Sun Cheung; Ching-Ning Chong; John Wong; Kit-Fai Lee; Henry Lik-Yuen Chan; Paul Bo-San Lai Journal: Ann Surg Date: 2013-05 Impact factor: 12.969