title: Clinical significance of hepatectomy for primary biliary cirrhosis patients with hepatocellular carcinoma: Report of a single center case series and review of the published work.
abstract: OBJECTIVE
  Hepatectomy for hepatocellular carcinoma (HCC) in patients with primary biliary cirrhosis (PBC) has seldom been reported, and the clinical significance of this procedure remains unclear, although HCC has often been observed in end-stage PBC patients.
  
  
  METHODS
  To understand the characteristics of hepatectomy on HCC in PBC patients, we examined seven cases at our institute, as well as 22 reported hepatectomy cases in the English-language and Japanese published work. Furthermore, to assess the treatment efficacy of hepatectomy for HCC in PBC patients, we compared these patients with viral hepatitis patients who underwent hepatectomies at our institute during the same period.
  
  
  RESULTS
  In the review of 29 cases, more than 70% of the patients were aged over 65 years, and the mean Mayo risk score was low at 5.17. The resected tumors were mainly solitary (79%), and the median maximum tumor size was 37 mm. Approximately two-thirds of the patients met the Milan criteria. In the comparison between the PBC and viral hepatitis cases, there were no differences in the postoperative prognoses, although the tumor size was greater in the PBC cases.
  
  
  CONCLUSIONS
  Hepatectomy for HCC in selected PBC cases is a feasible and potentially curative treatment option, similar to hepatectomy for HCC in viral hepatitis patients. This procedure is particularly useful for patients with preserved liver function who are not ideal candidates for liver transplantation.
authors.affiliation: Department of Digestive Surgery, Hepato Pancreato Biliary Surgery Unit, Toranomon Hospital, Tokyo, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Digestive Surgery, Hepato Pancreato Biliary Surgery Unit, Toranomon Hospital, Tokyo, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Department of Digestive Surgery, Hepato Pancreato Biliary Surgery Unit, Toranomon Hospital, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ohkura
authors.affiliation: Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kawamura
authors.affiliation: Department of Pathology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Digestive Surgery, Hepato Pancreato Biliary Surgery Unit, Toranomon Hospital, Tokyo, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada
authors.affiliation: Department of Digestive Surgery, Hepato Pancreato Biliary Surgery Unit, Toranomon Hospital, Tokyo, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Watanabe
keywords: hepatectomy; hepatocellular carcinoma; primary biliary cirrhosis; review