Is There any Benefit from Expanding the Criteria for the Resection of Hepatocellular Carcinoma in Cirrhotic Liver? Experience from a Developing Country

Galun, Danijel; Bulajic, Predrag; Zuvela, Marinko; Basaric, Dragan; Ille, Tatjana; Milicevic, Miroslav
July 2012
World Journal of Surgery;Jul2012, Vol. 36 Issue 7, p1657
Academic Journal
Background: Patients with large-size (>10 cm) hepatocellular carcinoma (HCC) in Child B cirrhosis are usually excluded from curative treatment, i.e., hepatic resection, because of marginal liver function and poor outcome. This study was designed to evaluate the feasibility of the radiofrequency (RF)-assisted sequential 'coagulate-cut liver resection technique' in expanding the criteria for resection of large HCC in cirrhotic livers with impaired liver function. Methods: Forty patients with Child-Pugh A or B cirrhosis underwent liver resection from December 1, 2001 to December 31, 2008. Of these, 20 patients (13 Child-Pugh A and 7 Child-Pugh B) with advanced stage HCC (stage B and C according to Barcelona-Clinic Liver Cancer Group) underwent major liver resection. The two groups were comparable in terms of patient age, liver cirrhosis etiology, tumor number, and size. Results: All resections were performed without the Pringle maneuver. There was no significant difference found between the two groups regarding resection time, perioperative transfusion, postoperative complications, hospital stay, and day 7 values of hemoglobin and liver enzymes. Likewise, there was no significant difference found in the overall survival between Child A and Child B patients who underwent major liver resection Conclusions: RF-assisted sequentional 'coagulate-cut liver resection technique' may be a viable alternative for management of patients with advanced HCC in cirrhotic liver with impaired function.


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