Clinical–Liver, Pancreas, and Biliary TractNeither Multiple Tumors Nor Portal Hypertension Are Surgical Contraindications for Hepatocellular Carcinoma
Section snippets
Materials and Methods
The study was undertaken in accordance with the Declaration of Helsinki.
Results
The median follow-up period after surgery was 46 months (range, 1–137 mo). Long-term overall survival was significantly poorer in the multiple group than in the single group: the 3-year/5-year overall survival rates were, respectively, 72%/58% in the multiple group and 81%/68% in the single group among patients with Child–Pugh class A cirrhosis (P = .035) and 33%/19% in the multiple group and 72%/45% in the single group among those with Child–Pugh class B cirrhosis (P = .013; Figure 1A). The
Discussion
In our series, liver resection was associated with a 5-year overall survival rate of nearly 60% in patients with HCC who had multiple tumors or PHT (or both), if their liver function remained within the range of Child–Pugh class A. The overall survival of these patients exceeded the currently accepted limit for curative treatment of HCC (a 5-year overall survival of 50%)22, 35 and compared favorably with previous results after resection (24%–60% for patients with multiple HCCs,1, 4, 6, 8, 9, 10
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Supported by a grant from the Kanae Foundation for Life & Socio-medical Science, a grant from the Public Trust Surgery Research Fund, a grant from the Japanese Clinical Oncology Fund, and a grant from the Public Trust Haraguchi Memorial Cancer Research Fund in Japan, and a Grant-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant 18790955).