title: Hepatocellular carcinoma: surgical treatment and prognostic variables in 56 patients.
abstract: OBJECTIVE
  Partial hepatectomy (PH) or total hepatectomy and orthotopic liver transplantation (OLT) may be curative in selected patients treated for hepatocellular carcinoma (HCC). The analysis of clinical series may help in the choice of the more appropriate treatment.
  
  
  METHODS
  During the past 11 years, 40 patients with HCC were treated by PH and 16 patients underwent total hepatectomy and OLT. Selection criteria for transplantation were the liver function and the tumor resectability.
  
  
  RESULTS
  The actuarial 1-, 3- and 5-year survival rates were 67%, 34% and 18%, respectively, after PH and 62%, 54% and 54% after OLT. The only prognostic factor after PH was the tumor extension to a single or both lobes. Patients with associated cirrhosis had significantly more post-operative complications, but a comparable long-term survival. The proliferative cell nuclear antigen labeling index (PCNA-LI), evaluated on tumoral tissue in 16 patients, showed that an index <30% indicates a better prognosis for HCC developing in non-cirrhotic liver.
  
  
  CONCLUSIONS
  For patients carefully pre-operatively evaluated, the presence of an associated cirrhosis does not seem to modify the long-term survival after PH, and OLT may offer more than 50% 5-year survival. A PCNA-LI <30% appears to be a good prognostic factor in patients without cirrhosis.
authors.affiliation: Medicosurgical Department of Gastroenterology, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Closset
authors.forename: J
authors.initials: J
authors.lastname: Van de Stadt
authors.forename: M
authors.initials: M
authors.lastname: Delhaye
authors.forename: I
authors.initials: I
authors.lastname: El Nakadi
authors.forename: J P
authors.initials: JP
authors.lastname: Lambilliotte
authors.forename: M
authors.initials: M
authors.lastname: Gelin
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate