There has been a 75% increase in hepatocellular carcinoma (HCC) in the United States the last decade.
Liver transplantation is an acceptable treatment for patients with early HCC, even when they have adequate liver function.
In this study, investigators from New York, USA, assessed the long-term outcome of patients with early HCC who were treated with partial hepatectomy, rather than transplantation.
The team evaluated 611 patients with HCC, between 1989 and 2001. Of these, 180 patients underwent partial hepatectomy; 20% of these patients satisfied the accepted criteria for transplantation.
The investigators used Kaplan-Meier analysis to measure patient survival.
|5-year disease-free survival was 48%.|
|Annals of Surgery|
The team found that the median tumor size was 3.5 cm, and the median number of lesions was 1.
Overall, 78% patients had pathologically confirmed cirrhosis, and 86% had normal liver function (Child class A).
The researchers found that perioperative morbidity was 25%. There was 1 perioperative death.
The team calculated the 1-, 3-, and 5-year overall survival as 85%, 74%, and 69%, respectively. Median survival was 71 months.
They also found that 5-year disease-free survival was 48%, with a median of 52 months.
Dr Charles Cha's team concluded, "Partial hepatectomy in patients with early HCC who are otherwise eligible for transplantation can be performed with minimal morbidity".
This procedure, "Can achieve comparable 5-year survival to that reported for liver transplantation".
"Resection should be considered the standard therapy for patients with HCC who have adequate liver reserve".