Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver Transplantation Center
Răzvan Grigorie, Sorin Alexandrescu, Gabriela Smira, Mihnea Ionescu, Doina Hrehoreţ, Vladislav Braşoveanu,Simona Dima, Silviu Ciurea, Patricia Boeţi, Ionut Dudus, Nausica Picu, Radu Zamfir, Leonard David,Florin Botea, Liana Gheorghe, Dana Tomescu, Ioana Lupescu, Mirela Boroş, Mugur Grasu, Radu Dumitru, Mihai Toma, Adina Croitoru, Vlad Herlea, Cătălin Pechianu, Anca Năstase, Irinel PopescuOriginal article, no. 3, 2017
Article DOI: 10.21614/chirurgia.112.3.289
Background: The objective of this study is to assess the outcome of the patients treated for hepatocellular carcinoma (HCC) in a General Surgery and Liver Transplantation Center. Methods: This retrospective study includes 844 patients diagnosed with HCC and surgically treated with curative intent methods. Curative intent treatment is mainly based on surgery, consisting of liver resection (LR), liver transplantation (LT). Tumor ablation could become the choice of treatment in HCC cases not manageable for surgery (LT or LR). 518 patients underwent LR, 162 patients benefited from LT and in 164 patients radiofrequency ablation (RFA) was performed. 615 patients (73%) presented liver cirrhosis. Results: Mordidity rates of patient treated for HCC was 30% and mortality was 4,3% for the entire study population. Five year overall survival rate was 39 % with statistically significant differences between transplanted, resected, or ablated patients (p 0.05) with better results in case of LT followed by LR and RFA. Conclusions: In HCC patients without liver cirrhosis, liver resection is the treatment of choice. For early HCC occurred on cirrhosis, LT offers the best outcome in terms of overall and disease free survival. RFA colud be a curative method for HCC patients not amenable for LT of LR.
Keywords: hepatocellular carcinoma, cirrhosis, liver resection, liver transplantation, radiofrequency ablation
