Authors: Peter Gassmann Tilmann Spieker Joerg Haier Fabian Schmidt Wolf Arif Mardin Norbert Senninger
Publish Date: 2010/06/11
Volume: 34, Issue: 10, Pages: 2442-2451
Abstract
In the case of hepatocellular carcinoma HCC underlying liver pathology may not only determine the feasibility of surgery but may also affect the postsurgical outcome We report our experience after curative liver resection for HCC in patients with normal liver liver fibrosis and liver cirrhosisA total of 72 patients after liver resection with curative intention were analyzed Histopathologic findings of tumorunaffected liver tissue were used for retrospective classification group A normal liver group B liver fibrosis group C liver cirrhosis The groups were compared for differences in shortterm surgical results total survival and recurrencefree survivalThe rate of major complications was 347 and did not significantly differ among groups The overall perioperative mortality rate was 97 with one patient dying in group A and three patients dying in each of the other two groups Including perioperative mortality the median overall survival for the whole group was 373 months 95 confidence interval 293–452 months The respective 1 2 and 5year survival rates for group A n = 21 were 86 71 and 50 and for group C n = 24 62 50 and 17 The overall survival of group B n = 27 was intermediate logrank P = 0032 The respective recurrencefree survival rates were 76 42 and 20 for group A and 39 13 and 4 for group C with group B being intermediate logrank P = 0016Our data demonstrate that liver resection in the presence of compensated liver cirrhosis is feasible but associated with a significantly impaired prognosis for overall and recurrencefree survival The management of cirrhotic patients with compensated liver function and HCC therefore also requires the opportunity for transplantation
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