Indications of partial hepatectomy for transplantable hepatocellular carcinoma with compensated cirrhosis.
BACKGROUND
The appropriate treatment strategy for transplantable hepatocellular carcinoma (HCC) patients with compensated cirrhosis remains controversial.


METHODS
Surgical outcomes were reviewed in 136 cirrhotic patients with transplantable HCC who had undergone partial hepatectomy. Transplantable HCC was defined as that corresponding to Milan's criteria.


RESULTS
The adverse prognostic factors for both survival and disease-free survival were histologic surgical margin of 5 mm or less, Child-Pugh B, and the presence of hepatitis C virus infection. The overall 5-year survival and disease-free survival rates of patients with 1 or none of the adverse prognostic factors were 73% and 33%, respectively, whereas those of patients with 2 or 3 adverse prognostic factors were 36% and 17%, respectively.


CONCLUSIONS
Transplantable HCC patients with 2 or 3 adverse prognostic factors should be considered candidates for liver transplantation, whereas patients with only 1 or none of the adverse prognostic factors are good candidates for partial hepatectomy.
Itamoto
Toshiyuki
T
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. titamoto@hiroshima-u.ac.jp
Nakahara
Hideki
H
Tashiro
Hirotaka
H
Ohdan
Hideki
H
Hino
Hiroshi
H
Ochi
Makoto
M
Asahara
Toshimasa
T
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome