title: R0 liver resections for primary malignant liver tumors in the noncirrhotic liver: a diagnosis-related analysis.
abstract: BACKGROUND
  Primary liver cancer constitutes an increasingly malignancy in the Western world and one of the leading causes of cancer-related deaths worldwide. The purpose of this study was to evaluate and compare long-term outcomes after R0 resections in noncirrhotic livers for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).
  
  
  METHODS
  Between April 1998 and May 2006 a total of 102 patients with either ICC (n = 41, group 1) or HCC (n = 61, group 2) in the absence of cirrhosis underwent curative liver resection in our department. Demographic characteristics, operative details, perioperative complications, pathologic findings, tumor recurrence and survival were analyzed.
  
  
  RESULTS
  Gender (P = 0.007), extent of liver resection (P = 0.036), additional surgical procedures (P < 0.001) and operative morbidity (P = 0.018) differed among the two groups. Following resection, after a median follow-up of 28 months, the calculated 5-year survival was 44% and 40% for ICC and HCC, respectively (P = 0.38). The corresponding recurrence-free survival was 25% for both ICC and HCC (P = 0.66). UICC stage was found to predict overall and recurrence-free survival in both types of tumors. Multifocality in the case of ICC, and tumor differentiation and vascular invasion in the case of HCC, were predictive factors for overall and recurrence-free survival, respectively. In multivariable analyses, vascular invasion for HCC was predictive for overall and recurrence-free survival, whereas in the case of ICC significant differences were detected in the recurrence analysis for multifocality and UICC stage.
  
  
  CONCLUSIONS
  R0 resections for both ICC and HCC result to similar long-term outcomes, which are characterized by good overall and acceptable recurrence-free survival rates.
authors: Department of General and Abdominal Surgery, University Hospital, Johannes Gutenberg University of Mainz, Langenbeckstrasse 1, D-55131, Mainz, Germany. sotiropoulos@ach.klinik.uni-mainz.de
authors: Georgios C
authors: GC
authors: Sotiropoulos
authors: Maximilian
authors: M
authors: Bockhorn
authors: George
authors: G
authors: Sgourakis
authors: Eirini I
authors: EI
authors: Brokalaki
authors: Ernesto P
authors: EP
authors: Molmenti
authors: Markus
authors: M
authors: Neuhäuser
authors: Arnold
authors: A
authors: Radtke
authors: Jeremias
authors: J
authors: Wohlschlaeger
authors: Hideo A
authors: HA
authors: Baba
authors: Christoph E
authors: CE
authors: Broelsch
authors: Hauke
authors: H
authors: Lang
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005858:Germany / Q000453:epidemiology; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D016896:Treatment Outcome