This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Chinese experience with hepatectomy for huge hepatocellular carcinoma. BJS 2004; 91: 322-326.
Published: 18th December 2003
Authors: X. P. Chen, F. Z. Qiu, Z. D. Wu, B. X. Zhang
Background
The risks and outcome of hepatic resection for huge hepatocellular carcinoma (HCC) are controversial.
Method
The clinical records of 525 patients who underwent resection of HCC greater than 10 cm in diameter were studied retrospectively. Prognostic factors for long‐term survival were evaluated by univariate and multivariate analyses.
Results
Postoperative complications were common (26·8 per cent) and five patients (0·9 per cent) required relaparotomy. The 30‐day mortality rate was 2·7 per cent. The main causes of postoperative death were liver failure (nine patients) and bleeding (four). The 3‐, 5‐ and 10‐year crude survival rates after liver resection were 34·3, 16·8 and 2·9 per cent respectively.
Conclusion
Prognostic factors for long‐term survival mainly reflected the biological behaviour of the tumour. They can be used only as a guide in balancing the risks of operation against the potential benefits of resection in a patient in poor general condition or with poor liver function. They cannot be used alone to exclude patients from liver resection with curative intent. Liver resection for huge HCC was safe and efficacious. It should be used to treat patients with acceptable surgical risks and resectable tumours. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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