Ilenia Bartolini1, Tommaso Nelli2, Nadia Russolillo3, Alessandro Cucchetti4, Benedetta Pesi2, Luca Moraldi5, Alessandro Ferrero3, Giorgio Ercolani4, Gianluca Grazi6, Giacomo Batignani2. 1. Department of Experimental and Clinical Medicine, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: ilenia.bartolini@gmail.com. 2. Department of Experimental and Clinical Medicine, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy. 3. Department of HPB and Digestive Surgery, Mauriziano Umberto I Hospital, Largo Filippo Turati 62, 10128, Turin, Italy. 4. Department of Emergency, Surgery, and Transplants, S. Orsola-Malpighi University Hospital, Via G. Massarenti 9, 40138, Bologna, Italy. 5. Surgical Oncology and Robotics, Department of Oncology, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy. 6. General and Hepatopancreatobiliary Surgery Unit, Regina Elena National Cancer Institute, Via E. Chianesi 53, 00128, Rome, Italy.
Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) is frequently diagnosed as multinodular. This study aims to assess prognostic factors for survival and identify patients with multiple HCC who may benefit from surgery beyond the Barcelona Clinic Liver Cancer classification indications. METHODS: This retrospective study included all the consecutive patients from 4 Italian tertiary centers receiving liver resection for naive multiple HCC between 1990 and 2012 to have a potential follow-up of 5 years. RESULTS: Included patients were 144. Ninety-day morbidity and mortality rates were 38.3% and 8.3%, respectively. The 5-year overall and disease-free survival rates were 33.3% and 19.1%, respectively. Tumor size <3 cm, bilirubin, Child-Pugh A, BCLC-A stage, being within "up-to-7" criteria, and minor resections resulted in prognostic factors. The Child-Pugh score resulted in an independent prognostic factor. CONCLUSIONS: Surgery may be related to good outcomes in selected patients with multiple HCC.
BACKGROUND:Hepatocellular carcinoma (HCC) is frequently diagnosed as multinodular. This study aims to assess prognostic factors for survival and identify patients with multiple HCC who may benefit from surgery beyond the Barcelona Clinic Liver Cancer classification indications. METHODS: This retrospective study included all the consecutive patients from 4 Italian tertiary centers receiving liver resection for naive multiple HCC between 1990 and 2012 to have a potential follow-up of 5 years. RESULTS: Included patients were 144. Ninety-day morbidity and mortality rates were 38.3% and 8.3%, respectively. The 5-year overall and disease-free survival rates were 33.3% and 19.1%, respectively. Tumor size <3 cm, bilirubin, Child-Pugh A, BCLC-A stage, being within "up-to-7" criteria, and minor resections resulted in prognostic factors. The Child-Pugh score resulted in an independent prognostic factor. CONCLUSIONS: Surgery may be related to good outcomes in selected patients with multiple HCC.