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Early cancer-related death after resection of hepatocellular carcinoma.
- Source :
-
Surgery [Surgery] 2012 Feb; Vol. 151 (2), pp. 232-7. Date of Electronic Publication: 2010 Dec 22. - Publication Year :
- 2012
-
Abstract
- Background: Surgeons have attempted to prevent early cancer-related death after resection of hepatocellular carcinoma to identify risk factors associated with early death from hepatocellular carcinoma recurrence after liver resection.<br />Methods: The study group comprised 350 patients who had undergone liver resection for hepatocellular carcinoma between 1997 and 2007. The preoperative risk factors for early death from intrahepatic recurrence (within 1 year after resection) were evaluated.<br />Results: Fourteen (4%) patients died of intrahepatic recurrence in the first year after resection. Multivariate analyses identified the following risk factors for early cancer-related death: multiple tumors (odds ratio 10.4; 95% confidence interval, 2.42-44.3; P = .002), vascular invasion (odds ratio 10.1; 95% confidence interval 2.07-50; P = .004), serum alpha-fetoprotein level >20 ng/mL (odds ratio 9.52; 95% confidence interval 1.0--84.2; P = .043), and tumor size ≥50 mm (odds ratio 4.80; 95% confidence interval 1.06-21.9; P = .042). Each of these factors was assigned a score of 1 point, and an algorithm was developed to predict the risk of early death. Outcomes did not differ significantly between patients with 3 or 4 points (P = .48) or between those with 1 or 2 points (P = .49). Patients who underwent liver resection could be stratified into the following distinct groups according to the point score and the associated 1-year survival rate and median survival (shown respectively): 0 points, 99%, and not yet; 1 or 2 points, 96%, and 68 months; and 3 or 4 points, 50%, and 12 months) (P < .0001).<br />Conclusion: Even if hepatocellular carcinoma is resectable, patients with a score of 3 or 4 points may not be good candidates for liver resection.<br /> (Copyright © 2012 Mosby, Inc. All rights reserved.)
- Subjects :
- Aged
Alanine Transaminase metabolism
Aspartate Aminotransferases metabolism
Carcinoma, Hepatocellular blood
Cohort Studies
Female
Follow-Up Studies
Humans
Liver enzymology
Liver pathology
Liver Neoplasms blood
Male
Multivariate Analysis
Neoplasm Recurrence, Local blood
Neoplasm Recurrence, Local diagnosis
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
alpha-Fetoproteins metabolism
Carcinoma, Hepatocellular diagnosis
Carcinoma, Hepatocellular surgery
Hepatectomy
Liver Neoplasms diagnosis
Liver Neoplasms surgery
Neoplasm Recurrence, Local mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1532-7361
- Volume :
- 151
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 21176935
- Full Text :
- https://doi.org/10.1016/j.surg.2010.10.017