title: Management of Advanced Hepatic Alveolar Echinococcosis: Report of 42 Cases.
abstract: Radical resection is the first choice for hepatic alveolar echinococcosis (HAE). However, many patients with advanced HAE have no chance to be treated with curative resection owing to the long clinical latency. This study aimed to evaluate the necessity of aggressive operations, like palliative resection and orthotopic liver transplantation (OLT), in the management of advanced HAE. A retrospective study analyzed 42 patients with advanced HAE treated with palliative resection (N= 15), palliative nonresective procedures (N= 13), OLT (N= 3), or albendazole therapy alone (N= 11). The patients' condition before treatments was comparable among all the four groups. The overall 1-year, 3-year, and 5-year survival rates of the 42 cases were 81.0%, 45.2%, and 23.8%, respectively. No event occurred to end the follow-up during the 5-year observation period except death. The survival time (median ± standard error) of the palliative resection group (3.6 ± 1.4 years) was longer than that of the palliative nonresective procedures group (1.5 ± 0.2) and the albendazole therapy-alone group (1.0 ± 0.4). The 5-year survival rates after palliative resection and liver transplantation were 40.0% and 66.7%, compared with only 7.7% and 9.1% after palliative nonresective procedures or albendazole therapy alone. Therefore, we concluded that aggressive treatment with a multimodality strategy could contribute to prolonged survival in patients with advanced HAE. Moreover, the prognosis of the patients who received albendazole therapy alone or palliative nonresective procedures is poor.
authors.affiliation: Department of General Surgery, Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces, Logistics University of Chinese People's Armed Police Forces, Tianjin, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Qu
authors.affiliation: Department of Hepatobiliary Surgery, Liver Transplantation Center, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Shaanxi, People's Republic of China.
authors.forename: Long
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of General Surgery, Postgraduate Training Basement of Jinzhou Medical University, Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces, Tianjin, People's Republic of China.
authors.forename: Guannan
authors.initials: G
authors.lastname: Sheng
authors.affiliation: Department of General Surgery, Postgraduate Training Basement of Jinzhou Medical University, Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces, Tianjin, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Postgraduate Training Basement of Jinzhou Medical University, Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces, Tianjin, People's Republic of China.
authors.forename: Guannan
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Oncology, Tianjin Beichen Hospital, Tianjin, People's Republic of China.
authors.forename: Yupeng
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Organ Transplantation Center, Tianjin First Center Hospital, Tianjin, People's Republic of China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University, Jinan, People's Republic of China.
authors.forename: Hanxiang
authors.initials: H
authors.lastname: Zhan
authors.affiliation: Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Hematology, Peking University Third Hospital, Peking University, Beijing, People's Republic of China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Du
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000871:Anthelmintics / Q000627:therapeutic use; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000871:Anthelmintics; D015766:Albendazole