title: Long-term results of hepatectomy for patients with alveolar echinococcosis: a single-center experience.
abstract: BACKGROUND
  Hepatectomy is the first-line treatment for alveolar echinococcosis (AE) if complete resection is feasible. However, a strategy for the treatment of patients with AE in whom the tumor cannot be resected completely remains to be defined.
  
  
  METHODS
  Data were retrospectively collected from 188 consecutive patients between 1984 and 2009. Overall survival (OS), progression-free survival (PFS), and risk factors were analyzed in patients classified into 3 groups (group A: complete resection, group B: reduction surgery, and group C: drainage or exploratory laparotomy).
  
  
  RESULTS
  In group A (n = 119), the 10-, 15-, and 20-year OS was 98.9%. In group B (n = 63), the 10-, 15-, and 20-year OS was 97.1%, 92.8%, and 61.9%. In group C (n = 6), the 10- and 15-year OS was 50.0% and 33.3%. Patients in groups A and B had better prognoses than those in group C (p < 0.001). In group A, the 10-, 15-, and 20-year PFS was 96.5%, 94.4%, and 94.4%. In group B, the 10-, 15-, and 20-year PFS was 87.1%, 71.6%, and 61.4%. In group C, the 10- and 15-year PFS was 50.0% and 33.3%. Patients in group A had better PFS than those in groups B and C (p < 0.001). Curability was the only independent factor for both OS and PFS by multivariate analysis.
  
  
  CONCLUSIONS
  Although the most effective therapy for AE is complete resection, a better prognosis can be achieved by reduction surgery and/or adjuvant albendazole therapy for patients with AE that cannot be completely resected.
authors.affiliation: Department of General Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. noriwon@mist.ocn.ne.jp
authors.forename: Norio
authors.initials: N
authors.lastname: Kawamura
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kamiyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Sato
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Hideki
authors.initials: H
authors.lastname: Yokoo
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kamachi
authors.forename: Munenori
authors.initials: M
authors.lastname: Tahara
authors.forename: Shoji
authors.initials: S
authors.lastname: Yamaga
authors.forename: Michiaki
authors.initials: M
authors.lastname: Matsushita
authors.forename: Satoru
authors.initials: S
authors.lastname: Todo
mesh_terms: D000704:Analysis of Variance; D000923:Anticestodal Agents / Q000627:therapeutic use; D015153:Blotting, Western; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000923:Anticestodal Agents