R0 liver resections for primary malignant liver tumors in the noncirrhotic liver

TY - JOUR

T1 - R0 liver resections for primary malignant liver tumors in the noncirrhotic liver

T2 - a diagnosis-related analysis

AU - Sotiropoulos, Georgios C

AU - Bockhorn, Maximilian

AU - Sgourakis, George

AU - Brokalaki, Eirini I

AU - Molmenti, Ernesto P

AU - Neuhäuser, Markus

AU - Radtke, Arnold

AU - Wohlschlaeger, Jeremias

AU - Baba, Hideo A

AU - Broelsch, Christoph E

AU - Lang, Hauke

PY - 2009/4/1

Y1 - 2009/4/1

N2 - BACKGROUND: Primary liver cancer constitutes an increasingly malignancy in the Western world and one of the leading causes of cancer-related deaths worldwide. The purpose of this study was to evaluate and compare long-term outcomes after R0 resections in noncirrhotic livers for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).METHODS: Between April 1998 and May 2006 a total of 102 patients with either ICC (n = 41, group 1) or HCC (n = 61, group 2) in the absence of cirrhosis underwent curative liver resection in our department. Demographic characteristics, operative details, perioperative complications, pathologic findings, tumor recurrence and survival were analyzed.RESULTS: Gender (P = 0.007), extent of liver resection (P = 0.036), additional surgical procedures (P < 0.001) and operative morbidity (P = 0.018) differed among the two groups. Following resection, after a median follow-up of 28 months, the calculated 5-year survival was 44% and 40% for ICC and HCC, respectively (P = 0.38). The corresponding recurrence-free survival was 25% for both ICC and HCC (P = 0.66). UICC stage was found to predict overall and recurrence-free survival in both types of tumors. Multifocality in the case of ICC, and tumor differentiation and vascular invasion in the case of HCC, were predictive factors for overall and recurrence-free survival, respectively. In multivariable analyses, vascular invasion for HCC was predictive for overall and recurrence-free survival, whereas in the case of ICC significant differences were detected in the recurrence analysis for multifocality and UICC stage.CONCLUSIONS: R0 resections for both ICC and HCC result to similar long-term outcomes, which are characterized by good overall and acceptable recurrence-free survival rates.

AB - BACKGROUND: Primary liver cancer constitutes an increasingly malignancy in the Western world and one of the leading causes of cancer-related deaths worldwide. The purpose of this study was to evaluate and compare long-term outcomes after R0 resections in noncirrhotic livers for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).METHODS: Between April 1998 and May 2006 a total of 102 patients with either ICC (n = 41, group 1) or HCC (n = 61, group 2) in the absence of cirrhosis underwent curative liver resection in our department. Demographic characteristics, operative details, perioperative complications, pathologic findings, tumor recurrence and survival were analyzed.RESULTS: Gender (P = 0.007), extent of liver resection (P = 0.036), additional surgical procedures (P < 0.001) and operative morbidity (P = 0.018) differed among the two groups. Following resection, after a median follow-up of 28 months, the calculated 5-year survival was 44% and 40% for ICC and HCC, respectively (P = 0.38). The corresponding recurrence-free survival was 25% for both ICC and HCC (P = 0.66). UICC stage was found to predict overall and recurrence-free survival in both types of tumors. Multifocality in the case of ICC, and tumor differentiation and vascular invasion in the case of HCC, were predictive factors for overall and recurrence-free survival, respectively. In multivariable analyses, vascular invasion for HCC was predictive for overall and recurrence-free survival, whereas in the case of ICC significant differences were detected in the recurrence analysis for multifocality and UICC stage.CONCLUSIONS: R0 resections for both ICC and HCC result to similar long-term outcomes, which are characterized by good overall and acceptable recurrence-free survival rates.

KW - Aged

KW - Bile Duct Neoplasms

KW - Bile Ducts, Intrahepatic

KW - Carcinoma, Hepatocellular

KW - Cholangiocarcinoma

KW - Disease-Free Survival

KW - Female

KW - Germany

KW - Hepatectomy

KW - Humans

KW - Male

KW - Middle Aged

KW - Monte Carlo Method

KW - Neoplasm Recurrence, Local

KW - Treatment Outcome

U2 - 10.1007/s10620-008-0408-6

DO - 10.1007/s10620-008-0408-6

M3 - SCORING: Journal article

C2 - 18712480

VL - 54

SP - 887

EP - 894

JO - DIGEST DIS SCI

JF - DIGEST DIS SCI

SN - 0163-2116

IS - 4

ER -