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Titolo:
Resection or transplantation for hepatocellular carcinoma in cirrhotic patients: Outcomes based on indicated treatment strategy
Autore:
Figueras, J; Jaurrieta, E; Valls, C; Ramos, E; Serrano, T; Rafecas, A; Fabregat, J; Torras, J;
Indirizzi:
Univ Barcelona, Ciutat Sanitaria Univ Bellvitge, Liver Transplant Unit, Barcelona, Spain Univ Barcelona Barcelona Spain Liver Transplant Unit, Barcelona, Spain
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
fascicolo: 5, volume: 190, anno: 2000,
pagine: 580 - 587
SICI:
1072-7515(200005)190:5<580:ROTFHC>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
ORTHOTOPIC LIVER-TRANSPLANTATION; SURGICAL-TREATMENT; INTRAHEPATIC RECURRENCE; RETROSPECTIVE ANALYSIS; HEPATIC RESECTION; EXPERIENCE; CHEMOEMBOLIZATION; CLASSIFICATION; SURVIVAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Figueras, J CSU Bellvitge, Serv Cirugia, Hosp Llobregat, C Feixa Llarga S-N, Barcelona08907, Spain CSU Bellvitge C Feixa Llarga S-N Barcelona Spain 08907 Spain
Citazione:
J. Figueras et al., "Resection or transplantation for hepatocellular carcinoma in cirrhotic patients: Outcomes based on indicated treatment strategy", J AM COLL S, 190(5), 2000, pp. 580-587

Abstract

Background: Surgical resection has been the treatment of choice for hepatocellular carcinoma (HCC), but the resection rate remains low in cirrhotic patients and recurrence is common. Unfavorable results compared with benign disease and the shortage of organ donors have led to a restricted indication for orthotopic liver transplantation (OLT) for HCC. Study Design: The aim of this study was to analyze the results of our surgical approach to HCC in patients with cirrhosis. The first treatment strategy indicated in these patients was OLT. From January 1990 to May 1999, 85 patients underwent OLT and the remaining 35 had surgical resection. Results: One-, 3-, and 5-year survival rates were 84%, 74%, and 60% versus83%, 57%, and 51%, respectively, in the OLT and resection groups (p = 0.34). Hepatic tumor recurrence was much less frequent in the OLT group than inthe resection group. The 1-, 3-, and 5-year disease-free survival rates were 83%, 72%, and 60% versus 70%, 44%, and 31%, respectively (p = 0.027). Inthe multivariate Cox regression analysis, macroscopic vascular invasion was the only factor independently associated with death or recurrence after OLT (p = 0.006). After partial liver resection, the tumors significantly associated with mortality and recurrence in the multivariate analysis were solitary or multiple tumors greater than 2 cm with microscopic vascular invasion (pathologic pT3) (p = 0.01). Conclusions: Our results confirm that in cirrhotic patients, OLT may provide better outcomes than liver resection in carefully selected HCC and that longterm survival is similar to the results of OLT in cirrhotic patients without tumors. (J Am Coil Surg 2000;190: 580-587. (C) 2000 by the American College of Surgeons).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 19:43:13