title: Hepatic resection in cirrhotic liver for treatment of hepatocellular carcinoma in Egyptian patients. Experience with 140 cases in a single center.
abstract: OBJECTIVE
  In many centers hepatic resection is still the treatment of choice for hepatocellular carcinoma in cirrhotic liver. Several factors affect the prognosis; one of them is the extent of resection. This study retrospectively evaluates outcome after different types of hepatic resection in cirrhotic liver.
  
  
  METHODS
  Hepatectomy was performed in 245 patients. From them, 140 patients were subjected to hepatic resection for hepatocellular carcinoma in cirrhotic liver. According to the type of resection the patients were divided into three groups (A, B and C), major resection (group A) in 79 (56.3%), segmental resection (group B) 31 (22.1%) and localized resection (group C) in 30 (21.4%). Early postoperative mortality and morbidity as well as long-term survival and recurrence were assessed.
  
  
  RESULTS
  The overall hospital mortality rate was (8.6%) with total complications 26%, recurrence rate 32.8% and median survival was 24 months (3-120). Group A showed high incidence rate of hospital mortality, total complications and hepatic cell failure than the other two types (p>0.05). On the other hand, group C patients showed high incidence of wound infection and recurrence rate after hepatic resection than the other two types (p>0.05). At the end of the study, the median survival was 18 months (4-120), 24 months (3-48) and 24 months (3-120) for the three groups respectively without significant difference. The overall 5-year survival rate was 20%, 0% and 15.3% for the three groups respectively (p>0.05).
  
  
  CONCLUSIONS
  Although major liver resection in cirrhotic liver has high incidence of early mortality and morbidity, it gives low incidence of recurrence and better survival in comparison with segmental and localized resection. However it has to be reserved for large tumor in good liver and early cirrhosis.
authors.affiliation: Gastroenterology Center, Mansoura University, Egypt. Wahab_M_eg@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Abdel Wahab
authors.forename: A
authors.initials: A
authors.lastname: Sultan
authors.forename: N
authors.initials: N
authors.lastname: el-Ghawalby
authors.forename: O
authors.initials: O
authors.lastname: Fathy
authors.forename: M
authors.initials: M
authors.lastname: Abu Zeid
authors.forename: A
authors.initials: A
authors.lastname: Abu el-Enin
authors.forename: T
authors.initials: T
authors.lastname: Abdallah
authors.forename: A
authors.initials: A
authors.lastname: Foad
authors.forename: T
authors.initials: T
authors.lastname: Kandeel
authors.forename: M
authors.initials: M
authors.lastname: el-Shobari
authors.forename: A
authors.initials: A
authors.lastname: el-Fiky
authors.forename: G
authors.initials: G
authors.lastname: el-Ebidy
authors.forename: N
authors.initials: N
authors.lastname: Gadel Hak
authors.forename: F
authors.initials: F
authors.lastname: Ezzat
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery* / Q000821:virology; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D017052:Hospital Mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies