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Predictive factors for long-term survival in patients with clinically significant portal hypertension following resection of hepatocellular carcinoma

Authors
 Gi H. Choi  ;  Jun Y. Park  ;  Woo J. Lee  ;  Chae Y. Chon  ;  Kwang-Hyub Han  ;  Sang H. Ahn  ;  Do Y. Kim  ;  Young N. Park  ;  Jin S. Choi  ;  Chang M. Kang  ;  Dong H. Kim  ;  Ho K. Hwang 
Citation
 Liver International, Vol.31(4) : 485-493, 2011 
Journal Title
 Liver International 
ISSN
 1478-3223 
Issue Date
2011
Abstract
BACKGROUND: Hepatic resection for hepatocellular carcinoma (HCC) is not currently recommended for patients with clinically significant portal hypertension (PHT); however, recent studies have shown similar post-operative outcomes between patients with and without clinically significant PHT. AIM: To clarify the post-operative prognostic relevance of clinically significant PHT in Child-Pugh A cirrhotic patients. METHODS: A total of 100 Child-Pugh A cirrhotic patients who underwent curative resection of HCC were eligible for this analysis. Patients were divided into two groups: PHT group (n=47) and non-PHT group (n=53). RESULTS: Clinicopathological variables showed no significant differences except for prothrombine time. Liver-related complications were significantly higher in the PHT group (P=0.015), and the 5-year overall survival rate was significantly higher in the non-PHT group (78.7 vs. 37.9%, P<0.001). The proportion of patients who died because of complications of cirrhosis was significantly higher in the PHT group (P=0.001). Multivariate analysis indicated that the presence of clinically significant PHT was the most powerful adverse prognostic factor for overall survival. Multivariate analysis of the 47 patients with clinically significant PHT indicated that gross vascular invasion and non-single nodular type were poor prognostic factors. The 5-year survival rate of patients with single nodular type and without gross vascular invasion (n=17) was 78.4%. CONCLUSIONS: In Child-Pugh A cirrhotic patients, the presence of clinically significant PHT was significantly associated with post-operative hepatic decompensation and poor prognosis after resection of HCC. However, in patients with clinically significant PHT, those with single nodular tumours lacking gross vascular invasion may be good surgical candidates.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93092
DOI
10.1111/j.1478-3231.2010.02436.x
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
강창무(Kang, Chang Moo) ; 김도영(Kim, Do Young) ; 박영년(Park, Young Nyun) ; 박준용(Park, Jun Yong) ; 안상훈(Ahn, Sang Hoon) ; 이우정(Lee, Woo Jung) ; 전재윤(Chon, Chae Yoon) ; 최기홍(Choi, Gi Hong) ; 최진섭(Choi, Jin Sub) ; 한광협(Han, Kwang Hyup) ; 황호경(Hwang, Ho Kyoung)
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Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2010.02436.x/abstract
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