Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 22 April 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Preoperative predictors of survival after resection of small HCC are identified

Patients with small hepatocellular cancers, who will derive the least benefit from resection, can be identified before surgery, using a score based on tumor grade and severity of underlying liver disease, claim researchers from the USA, Japan, and France.

News image

fiogf49gjkf04

The team determined preoperative predictors of survival that can guide the choice of treatment for patients with small hepatocellular cancers (HCCs).

The findings of the trial were published in the May issue of the Annals of Surgery.

Currently, the treatment of patients with small (≤ 5 cm in diameter) HCCs is controversial.

A cohort of 249 patients (69 women, median age 62 years) who underwent resection with curative intent for small HCC was identified from a multiinstitutional database.

For each patient, the clinical data and pathology slides were reviewed.

A total of 6 clinical factors (age, gender, preoperative alpha-fetoprotein level, hepatitis serology, number of tumors [single vs multiple], and Child-Pugh score) and 3 pathologic factors (hepatitis activity score, fibrosis score, and Edmondson-Steiner tumor grade) were assessed before surgery.

All of these factors were correlated with survival.

The researchers found that median overall survival for the entire cohort was 4.2 years.

Predictors of survival after resection:
- Fibrosis score
- Edmondson-Steiner grade
- Child-Pugh score
Annals of Surgery
The estimated overall 5- and 8-year survival rates were 41% and 20%, respectively.

Multivariate Cox analysis indicated that fibrosis score, Edmondson-Steiner grade, and Child-Pugh score were simultaneously significant predictors of survival after resection.

The team derived a prognostic scoring system based on these covariates and applied it to the entire cohort.

Patients lacking all 3 risk factors were assigned a score of 1, patients with 1 risk factor were assigned a score of 2, and patients with 2 or 3 risk factors were assigned a score of 3.

Pairwise log-rank tests indicated significant differences in survival between scores 1 and 2, scores 2 and 3, and scores 1 and 3.

A subset of 98 patients, with positive hepatitis C serology, was analyzed separately. This scoring system was still found to retain its prognostic significance.

Dr Jeffrey D. Wayne, of the University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA, said on behalf of his colleagues, "Patients with small HCCs, who will derive the least benefit from resection, can be identified before surgery.

"This can be done using a score based on tumor grade and the severity of underlying liver disease."

"In these patients, transplantation and/or ablation should be considered as possible alternative therapies,"

Ann Surg 2002; 235(5): 722-31
02 May 2002

Go to top of page Email this page Email this page to a colleague

 20 April 2018 
Obesity and physical activity in diverticulosis
 20 April 2018 
Worldwide H.pylori prevalence
 20 April 2018 
Adalimumab with azathioprine in Crohn's
 20 April 2018 
Antibody suitable for further clinical development to complement existing therapeutic strategies for HCV
 19 April 2018 
Fibrosis in patients with chronic hepatitis B
 19 April 2018 
c-Myc expression and pancreatic cancer
 19 April 2018 
Olmesartan prescription in the USA
 18 April 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 18 April 2018 
Hep C treatment for sustained virologic response
 18 April 2018 
Endoscopic necrosectomy reduces risk of death 
 17 April 2018 
Colorectal cancer screening and ethnic inequities
 17 April 2018 
Training programs should consider radiation education for advanced endoscopy fellows
 17 April 2018 
Aspirin and pancreatic cancer
 16 April 2018 
Surgery for colorectal polyps has increased 
 16 April 2018 
Advanced fibrosis can be ruled out in primary health care patients
 16 April 2018 
Antibiotic use and colorectal adenoma
 13 April 2018 
Colorectal cancer cell lines
 13 April 2018 
Infliximab and corticosteroid-free clinical remission in Crohn's
 13 April 2018 
Teduglutide for children with short bowel syndrome
 12 April 2018 
Prescriptions for opiate drugs amongst primary care patients with IBD
 12 April 2018 
Lower GI bleeding related to comorbidity
 12 April 2018 
non–Clostridium difficile bacterial infections in IBD
 11 April 2018 
Physician perception of IBD trial results
 11 April 2018 
Bile acid deficiency in IBS 
 11 April 2018 
Stem cell therapy for fistulas in Crohn's
 10 April 2018 
Overweight in childhood and type 2 diabetes
 10 April 2018 
immunoglobulin G associates with clinical features of IBD
 10 April 2018 
T-cells repertoires in celiac disease
 09 April 2018 
Biomarker tests for colorectal cancer screening
 09 April 2018 
Fecal transplantation in C. difficile infection and treatment outcome 
 09 April 2018 
No weigh-loss drug improved all cardiometabolic risk factors
 06 April 2018 
Colonoscopy and colorectal cancer mortality
 06 April 2018 
Eosinophilic esophagitis and health-related quality of life
 06 April 2018 
Microbiome in athletes vs sedentary subjects
 05 April 2018 
Laparoscopic Nissen fundoplication for GERD treatment
 05 April 2018 
Random biopsies for neoplasia in IBD
 05 April 2018 
Scoring system identifies cancer risk in Barrett's
 04 April 2018 
Alpha‐1 antitrypsin deficiency and liver disease
 04 April 2018 
PPI and risk of stroke
 04 April 2018 
Adjuvant chemotherapy for advanced colon cancer
 29 March 2018 
Prevention of metachronous gastric cancer
 29 March 2018 
Acute lower GI bleeding
 28 March 2018 
Decision aid used by IBD patients
 28 March 2018 
Transition for young adults with IBD
 28 March 2018 
Amitriptyline in functional dyspepsia
 27 March 2018 
Emergency department utilization for IBD 
 27 March 2018 
Management of hemorrhoids in the USA
 27 March 2018 
Adult ulcerative colitis
 26 March 2018 
Biological therapy response in IBD 
 26 March 2018 
Obesity and diverticulosis
 26 March 2018 
Practice guidelines for chronic constipation
 23 March 2018 
Health-related quality of life in eosinophilic esophagitis
 23 March 2018 
Genetics and chronic liver disease
 23 March 2018 
Global prevalence of H.pylori
 22 March 2018 
H. pyloris and gastric cancer
 22 March 2018 
Pancreatitis after IBS treatment 
 22 March 2018 
Mechanisms of action in patients with IBS
 21 March 2018 
Panel markers for early detection of colon cancer

 21 March 2018 
Blood test differentiates celiac disease
 21 March 2018 
Patient characteristics and colonoscopy preparation

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us