Jayanand Sunil Bhanu1,2, Balasubramanian Venkitaraman3, Ravisankar Palaniappan4, Rama Ranganathan5, Ramakrishnan Ayloor Seshadri6, Vikash Mahajan7. 1. Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, India. drsunilbjs@yahoo.co.in. 2. Division of GI & HPB Oncology, Department of Surgical Oncology, Cancer Institute (WIA), No.38, Sardar Patel Road, Guindy, Chennai, 600036, India. drsunilbjs@yahoo.co.in. 3. Department of Surgical Oncology, Sri Ramachandra Medical College and Research Institute, Chennai, India. 4. Department of Surgical Oncology, Sri Venkateshwaraa Medical College, Puducherry, India. 5. Department of Biostatistics, Cancer Institute (WIA), Adyar, Chennai, India. 6. Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, India. 7. Madras Cancer Care Foundation, Chennai, India.
Abstract
INTRODUCTION: The aim of the study was to analyze the various prognostic factors that influence survival and clinical outcomes in patients undergoing liver resection for huge hepatocellular carcinomas. MATERIALS AND METHODS: The records of patients who underwent curative surgery between 1991 and 2011 for huge hepatocellular carcinoma were analyzed. Various prognostic factors that influenced the survival were studied. The patients were followed up till November 2016. RESULTS: The number of patients who underwent liver resection with huge hepatocellular carcinoma during the study period was 17; this included 14 males and 3 females. The median age of the study population was 52 years. The median serum AFP in the study population was 132.3 ng/ml (range 2 to 187,000 ng/ml). 41.2% of the patients were hepatitis B positive. The overall morbidity was 6%. The mortality rate was nil. The mean size of the resected specimen was 13.9 cm ± 3.6 cm. The overall recurrence rate was 76.5%. The local recurrence rate was 29.4%. The median time to recurrence was 8 months. The 5-year disease-free survival and overall survival of the study group were 26% and 32%, respectively. The factors that predicted an adverse survival outcome after the log-rank test for univariate analysis using life-table method were presence of lymphovascular invasion (p = 0.047), age ≤ 55 years (p = 0.021), and raised serum AFP (p = 0.041). CONCLUSION: The factors that predict an adverse outcome after surgery in patients with huge hepatocellular carcinomas were the presence of lymphovascular invasion, raised serum AFP, and age ≤ 55 years.
INTRODUCTION: The aim of the study was to analyze the various prognostic factors that influence survival and clinical outcomes in patients undergoing liver resection for huge hepatocellular carcinomas. MATERIALS AND METHODS: The records of patients who underwent curative surgery between 1991 and 2011 for huge hepatocellular carcinoma were analyzed. Various prognostic factors that influenced the survival were studied. The patients were followed up till November 2016. RESULTS: The number of patients who underwent liver resection with huge hepatocellular carcinoma during the study period was 17; this included 14 males and 3 females. The median age of the study population was 52 years. The median serum AFP in the study population was 132.3 ng/ml (range 2 to 187,000 ng/ml). 41.2% of the patients were hepatitis B positive. The overall morbidity was 6%. The mortality rate was nil. The mean size of the resected specimen was 13.9 cm ± 3.6 cm. The overall recurrence rate was 76.5%. The local recurrence rate was 29.4%. The median time to recurrence was 8 months. The 5-year disease-free survival and overall survival of the study group were 26% and 32%, respectively. The factors that predicted an adverse survival outcome after the log-rank test for univariate analysis using life-table method were presence of lymphovascular invasion (p = 0.047), age ≤ 55 years (p = 0.021), and raised serum AFP (p = 0.041). CONCLUSION: The factors that predict an adverse outcome after surgery in patients with huge hepatocellular carcinomas were the presence of lymphovascular invasion, raised serum AFP, and age ≤ 55 years.
Authors: Brian K P Goh; Juinn Huar Kam; Ser-Yee Lee; Chung-Yip Chan; John C Allen; Premaraj Jeyaraj; Peng-Chung Cheow; Pierce K H Chow; London L P J Ooi; Alexander Y F Chung Journal: J Surg Oncol Date: 2016-02-10 Impact factor: 3.454
Authors: F Y Yao; L Ferrell; N M Bass; J J Watson; P Bacchetti; A Venook; N L Ascher; J P Roberts Journal: Hepatology Date: 2001-06 Impact factor: 17.425