Format

Send to

Choose Destination
World J Surg. 2017 Nov;41(11):2830-2837. doi: 10.1007/s00268-017-4096-2.

Central Hepatectomy Still Plays an Important Role in Treatment of Early-Stage Centrally Located Hepatocellular Carcinoma.

Author information

1
Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan.
2
Division of General Surgery, Liver Transplant Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 123 Ta-Pei Road, Niao-Song, Kaohsiung, 833, Taiwan.
3
Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan. ufel4996@ms26.hinet.net.
4
Division of General Surgery, Liver Transplant Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 123 Ta-Pei Road, Niao-Song, Kaohsiung, 833, Taiwan. ufel4996@ms26.hinet.net.

Abstract

BACKGROUND:

Surgical management of centrally located hepatocellular carcinoma (CL-HCC) poses a great challenge. Major hepatectomy (MH) might compromise future remnant liver volume (FRLV), while the long-term benefits of central hepatectomy (CH) had not been well demonstrated.

METHODS:

Consecutive patients with early-stage CL-HCC who underwent liver resection were enrolled. Fifteen patients underwent CH, while thirty-three were subjected to MH. All relevant clinicopathological variables were analyzed. Disease-free survival (DFS) and overall survival (OS) of both groups were compared.

RESULTS:

There were no differences between CH and MH in terms of predisposing liver disease, tumor size, blood loss, complication rate and vascular invasion. Mean FRLV increased from 40.9 to 69.2% by using CH resection lines. The parenchymal transection time is longer in CH. There were no differences of DFS between two groups. The 5-year OS rates of CH and MH were 93.3 and 62.6%, respectively. MH was a poor prognostic factor.

CONCLUSIONS:

CH is a relatively time-consuming and technique-demanding procedure, but excellent long-term survival could be achieved. CH could increase liver volume preservation without compromising intra-hepatic recurrence. In an endemic area of hepatitis and cirrhosis, CH should still play an important role in surgical treatment of CL-HCC.

PMID:
28639005
DOI:
10.1007/s00268-017-4096-2
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center