Dr Abraham John and colleagues conducted a retrospective analysis of resection for hepatocellular carcinomas in a tertiary Hepatobiliary and Liver Transplant Unit in England.
The investigators assessed 715 cases of hepatocellular carcinoma.
Of these, 100 underwent hepatic resection and 159 orthotopic liver transplantation.
The investigative team found that the 1-, 3- and 5-year overall survival following resection was 75%, 37%, and 22%, respectively.
Factors affecting long-term survival included resection margin, recurrence, -fetoprotein of more than 50 and serum albumin.
On multivariate analysis, the team noted that recurrence and histological grade were significant.
|The 1- and 3-year recurrence rates were 27% and 73%|
The 1- and 3-year recurrence rates were 27%, and 73% respectively.
The investigators observed that histological grade, -fetoprotein higher than 50, female gender, and portal vein involvement were significant in recurrence.
Dr John's team commented, “Resection data from the East may not be comparable to the West owing to the higher transplant activity in the latter.”
“Liver function tests and imaging would be sufficient to assess liver function prior to hepatic resection.”
“Hepatocellular carcinoma with cirrhosis should be assessed by a transplant unit prior to any treatment.”
“The Model for End-Stage Liver Disease score would be a valuable preoperative tool in the assessment of cirrhotics.”