Hepatic resection for hepatocellular carcinoma existing with liver cirrhosis

Takahiro Ezaki, Kazuharu Yamamoto, Hiroshi Yamaguchi, Yukiharu Sasaki, Teruyoshi Ishida, Masaki Mori, Shiomi Aimitsu

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background/Aims: Hepatocellular carcinoma is usually complicated with liver cirrhosis, which makes its treatment difficult. Also a high rate of recurrence exists after surgical resection. However, how the prognosis after surgical treatment is affected by the severity of coexisting cirrhosis has not been clarified. Methodology: We compared the postoperative long-term courses of hepatocellular carcinoma patients with cirrhosis according to the liver function. All 112 hepatocellular carcinoma patients in this study underwent curative hepatic resection, and were classified into three groups according to the severity of liver dysfunction. The ICG R15' (indocyanine green retention test) (normal: <10%) was used in this study. Patients whose ICG R15' was less than 20% were classified as group I of 62, patients equal to 20% or between 20% and 30% as group II of 24, and patients equal to and more than 30% as group III of 26. Results: In this series, 76 of 112 patients had recurrence (68%). A second hepatic resection was performed in six cases of group I and one case in group II. Fifty-eight of 76 recurrent cases (76%) were treated with transcatheter arterial chemoembolization. A total of eleven cases had no transcatheter arterial chemoembolization in the three groups: 3 cases in group I, 5 cases in group II, and 3 cases in group III; The three cases of group III had no treatment because of extremely poor liver dysfunction, whilst the 8 patients without transcatheter arterial chemoembolization in groups I and II had hepatocellular carcinoma itself and other diseases. The 1-, 3-, and 5-year survival rates after recurrence were 92%, 48%, and 14%, respectively, in group I; 83%, 37%, 12%, respectively, in group II; and 66%, 30%, 0%, respectively, in group III. The prognosis was significantly worse according to the degree of liver dysfunction (p=0.0206). Conclusions: The prognosis of hepatocellular carcinoma with liver cirrhosis is affected not only by hepatocellular carcinoma itself, but also by the severity of the coexisting cirrhosis. Moreover, the cirrhotic liver can decline due to surgery. Surgical resection of this disease should be performed after careful patient selection and using a less invasive technique.

Original languageEnglish
Pages (from-to)1363-1368
Number of pages6
JournalHepato-gastroenterology
Volume49
Issue number47
Publication statusPublished - Oct 1 2002
Externally publishedYes

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Liver Cirrhosis
Hepatocellular Carcinoma
Liver
Liver Diseases
Fibrosis
Recurrence
Indocyanine Green
Patient Selection
Therapeutics
Survival Rate

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Ezaki, T., Yamamoto, K., Yamaguchi, H., Sasaki, Y., Ishida, T., Mori, M., & Aimitsu, S. (2002). Hepatic resection for hepatocellular carcinoma existing with liver cirrhosis. Hepato-gastroenterology, 49(47), 1363-1368.

Hepatic resection for hepatocellular carcinoma existing with liver cirrhosis. / Ezaki, Takahiro; Yamamoto, Kazuharu; Yamaguchi, Hiroshi; Sasaki, Yukiharu; Ishida, Teruyoshi; Mori, Masaki; Aimitsu, Shiomi.

In: Hepato-gastroenterology, Vol. 49, No. 47, 01.10.2002, p. 1363-1368.

Research output: Contribution to journalArticle

Ezaki, T, Yamamoto, K, Yamaguchi, H, Sasaki, Y, Ishida, T, Mori, M & Aimitsu, S 2002, 'Hepatic resection for hepatocellular carcinoma existing with liver cirrhosis', Hepato-gastroenterology, vol. 49, no. 47, pp. 1363-1368.
Ezaki T, Yamamoto K, Yamaguchi H, Sasaki Y, Ishida T, Mori M et al. Hepatic resection for hepatocellular carcinoma existing with liver cirrhosis. Hepato-gastroenterology. 2002 Oct 1;49(47):1363-1368.
Ezaki, Takahiro ; Yamamoto, Kazuharu ; Yamaguchi, Hiroshi ; Sasaki, Yukiharu ; Ishida, Teruyoshi ; Mori, Masaki ; Aimitsu, Shiomi. / Hepatic resection for hepatocellular carcinoma existing with liver cirrhosis. In: Hepato-gastroenterology. 2002 ; Vol. 49, No. 47. pp. 1363-1368.
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abstract = "Background/Aims: Hepatocellular carcinoma is usually complicated with liver cirrhosis, which makes its treatment difficult. Also a high rate of recurrence exists after surgical resection. However, how the prognosis after surgical treatment is affected by the severity of coexisting cirrhosis has not been clarified. Methodology: We compared the postoperative long-term courses of hepatocellular carcinoma patients with cirrhosis according to the liver function. All 112 hepatocellular carcinoma patients in this study underwent curative hepatic resection, and were classified into three groups according to the severity of liver dysfunction. The ICG R15' (indocyanine green retention test) (normal: <10{\%}) was used in this study. Patients whose ICG R15' was less than 20{\%} were classified as group I of 62, patients equal to 20{\%} or between 20{\%} and 30{\%} as group II of 24, and patients equal to and more than 30{\%} as group III of 26. Results: In this series, 76 of 112 patients had recurrence (68{\%}). A second hepatic resection was performed in six cases of group I and one case in group II. Fifty-eight of 76 recurrent cases (76{\%}) were treated with transcatheter arterial chemoembolization. A total of eleven cases had no transcatheter arterial chemoembolization in the three groups: 3 cases in group I, 5 cases in group II, and 3 cases in group III; The three cases of group III had no treatment because of extremely poor liver dysfunction, whilst the 8 patients without transcatheter arterial chemoembolization in groups I and II had hepatocellular carcinoma itself and other diseases. The 1-, 3-, and 5-year survival rates after recurrence were 92{\%}, 48{\%}, and 14{\%}, respectively, in group I; 83{\%}, 37{\%}, 12{\%}, respectively, in group II; and 66{\%}, 30{\%}, 0{\%}, respectively, in group III. The prognosis was significantly worse according to the degree of liver dysfunction (p=0.0206). Conclusions: The prognosis of hepatocellular carcinoma with liver cirrhosis is affected not only by hepatocellular carcinoma itself, but also by the severity of the coexisting cirrhosis. Moreover, the cirrhotic liver can decline due to surgery. Surgical resection of this disease should be performed after careful patient selection and using a less invasive technique.",
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AU - Ezaki, Takahiro

AU - Yamamoto, Kazuharu

AU - Yamaguchi, Hiroshi

AU - Sasaki, Yukiharu

AU - Ishida, Teruyoshi

AU - Mori, Masaki

AU - Aimitsu, Shiomi

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N2 - Background/Aims: Hepatocellular carcinoma is usually complicated with liver cirrhosis, which makes its treatment difficult. Also a high rate of recurrence exists after surgical resection. However, how the prognosis after surgical treatment is affected by the severity of coexisting cirrhosis has not been clarified. Methodology: We compared the postoperative long-term courses of hepatocellular carcinoma patients with cirrhosis according to the liver function. All 112 hepatocellular carcinoma patients in this study underwent curative hepatic resection, and were classified into three groups according to the severity of liver dysfunction. The ICG R15' (indocyanine green retention test) (normal: <10%) was used in this study. Patients whose ICG R15' was less than 20% were classified as group I of 62, patients equal to 20% or between 20% and 30% as group II of 24, and patients equal to and more than 30% as group III of 26. Results: In this series, 76 of 112 patients had recurrence (68%). A second hepatic resection was performed in six cases of group I and one case in group II. Fifty-eight of 76 recurrent cases (76%) were treated with transcatheter arterial chemoembolization. A total of eleven cases had no transcatheter arterial chemoembolization in the three groups: 3 cases in group I, 5 cases in group II, and 3 cases in group III; The three cases of group III had no treatment because of extremely poor liver dysfunction, whilst the 8 patients without transcatheter arterial chemoembolization in groups I and II had hepatocellular carcinoma itself and other diseases. The 1-, 3-, and 5-year survival rates after recurrence were 92%, 48%, and 14%, respectively, in group I; 83%, 37%, 12%, respectively, in group II; and 66%, 30%, 0%, respectively, in group III. The prognosis was significantly worse according to the degree of liver dysfunction (p=0.0206). Conclusions: The prognosis of hepatocellular carcinoma with liver cirrhosis is affected not only by hepatocellular carcinoma itself, but also by the severity of the coexisting cirrhosis. Moreover, the cirrhotic liver can decline due to surgery. Surgical resection of this disease should be performed after careful patient selection and using a less invasive technique.

AB - Background/Aims: Hepatocellular carcinoma is usually complicated with liver cirrhosis, which makes its treatment difficult. Also a high rate of recurrence exists after surgical resection. However, how the prognosis after surgical treatment is affected by the severity of coexisting cirrhosis has not been clarified. Methodology: We compared the postoperative long-term courses of hepatocellular carcinoma patients with cirrhosis according to the liver function. All 112 hepatocellular carcinoma patients in this study underwent curative hepatic resection, and were classified into three groups according to the severity of liver dysfunction. The ICG R15' (indocyanine green retention test) (normal: <10%) was used in this study. Patients whose ICG R15' was less than 20% were classified as group I of 62, patients equal to 20% or between 20% and 30% as group II of 24, and patients equal to and more than 30% as group III of 26. Results: In this series, 76 of 112 patients had recurrence (68%). A second hepatic resection was performed in six cases of group I and one case in group II. Fifty-eight of 76 recurrent cases (76%) were treated with transcatheter arterial chemoembolization. A total of eleven cases had no transcatheter arterial chemoembolization in the three groups: 3 cases in group I, 5 cases in group II, and 3 cases in group III; The three cases of group III had no treatment because of extremely poor liver dysfunction, whilst the 8 patients without transcatheter arterial chemoembolization in groups I and II had hepatocellular carcinoma itself and other diseases. The 1-, 3-, and 5-year survival rates after recurrence were 92%, 48%, and 14%, respectively, in group I; 83%, 37%, 12%, respectively, in group II; and 66%, 30%, 0%, respectively, in group III. The prognosis was significantly worse according to the degree of liver dysfunction (p=0.0206). Conclusions: The prognosis of hepatocellular carcinoma with liver cirrhosis is affected not only by hepatocellular carcinoma itself, but also by the severity of the coexisting cirrhosis. Moreover, the cirrhotic liver can decline due to surgery. Surgical resection of this disease should be performed after careful patient selection and using a less invasive technique.

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