Short-term outcomes following hepatectomy for hepatocellular carcinoma within and beyond the BCLC guidelines A prospective study

被引:11
作者
Lim, Chetana [1 ,2 ]
Salloum, Chady [1 ]
Osseis, Michael [1 ]
Lahat, Eylon [1 ]
Gomez-Gavara, Concepcion [1 ]
Compagnon, Philippe [1 ,2 ,3 ]
Luciani, Alain [2 ,3 ,4 ]
Feray, Cyrille [2 ,3 ,5 ]
Azoulay, Daniel [1 ,2 ,3 ]
机构
[1] Henri Mondor Hosp, AP HP, Dept Hepatobiliary & Pancreat Surg & Liver Transp, Creteil, France
[2] Univ Paris 12, UPEC, Creteil, France
[3] INSERM 955, Creteil, France
[4] Henri Mondor Hosp, AP HP, Dept Radiol, Creteil, France
[5] Henri Mondor Hosp, AP HP, Dept Hepatol, Creteil, France
关键词
TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; OPEN LIVER RESECTION; SURGICAL RESECTION; RADIOFREQUENCY ABLATION; HEPATIC RESECTION; MILAN CRITERIA; PORTAL-HYPERTENSION; PROGNOSTIC VALUE; CLINICAL-TRIAL; SURGERY;
D O I
10.1016/j.hpb.2017.08.027
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Western guidelines recommend resection for hepatocellular carcinoma (HCC) in so-called ideal cirrhotic patients with a Barcelona Clinic Liver Cancer (BCLC) stage 0-A tumour. This study compares short-term outcomes following resection between patients defined as ideal and nonideal according to the BCLC guidelines. Methods: This prospective single-centre open study (ClinicalTrials. gov NCT02145013) included all cirrhotic patients with HCC referred for resection from 2014 to 2016. Mortality, morbidity, unresolved liver decompensation, and readmission were measured. Results: The study population included 65 consecutive patients: 32 (49%) ideal and 33 (51%) nonideal. Ideal and nonideal groups did not differ in mortality (3% vs. 6%; p = 0.57), morbidity (53% vs. 73%; p = 0.10), or unresolved liver decompensation (6% vs. 15%; p = 0.23) at 90 days. The readmission rate was higher in the nonideal (21%) than in the ideal group (3%; p = 0.02). Conclusion: Straying from the current guidelines for resection in a selected subset of nonideal patients doubled the number of resections performed for treating HCC, with satisfactory short-term outcomes. These results argue for the expansion of the acknowledged BCLC guidelines.
引用
收藏
页码:222 / 230
页数:9
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