Hepatectomy for hepatocellular carcinoma patients who meet the Milan criteria.
OBJECTIVE
Although hepatocellular carcinoma patients who meet the Milan criteria are optimal candidates for liver transplantation, most such patients in Japan have been treated without liver transplantation.


METHODS
In this retrospective analysis, the patient selection criteria were (1) admission between 1992 and 2005, (2) fulfillment of the Milan criteria, (3) classification within the Barcelona Clinic Liver Cancer stages A1-A4, and (4) no previous anticancer treatment.


RESULTS
Of 451 patients who met the selection criteria, 162 underwent hepatectomy. The proportion of patients who underwent hepatectomy was 58% of 106 with stage A1 and 29% of 345 with stages A2-A4. For patients with stages A2-A4, the survival probability after hepatectomy at 3, 5, and 7 years was 89%, 70%, and 61%, respectively. There were no significant differences in survival time between stages A1 and stages A2-A4 after hepatectomy. Among patients with Child-Pugh scores of 5 and 6 in stages A2-A4, 51% and 29% underwent hepatectomy, respectively.


CONCLUSIONS
Hepatectomy may be an appropriate first-line treatment option for patients with stages A2-A4 who meet the Milan criteria, when they have a good hepatic reserve and a long waiting time for liver transplantation.
Ishii
Hiroshi
H
Division of Hepatobiliary and Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan. hirishii@east.ncc.go.jp
Furuse
Junji
J
Kinoshita
Taira
T
Konishi
Masaru
M
Nakagohri
Toshio
T
Takahashi
Shinichiro
S
Gotohda
Naoto
N
Nakachi
Kohei
K
Suzuki
Ei-ichiro
E
Yoshino
Masahiro
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies