CLDF Title
Home | Contact Us | Bookmark
HBV HE HCC HCV
About CLDF Centers of Educational Expertise  
CME Dinner Meetings Telewebs Webcasts Slide Library Abstract Library Conference Highlights
 
Back  
 
Reuters Health Information (2011-03-01): Survival after hepatoma resection continues to improve

Epidemiology

Survival after hepatoma resection continues to improve

Last Updated: 2011-03-01 13:43:24 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Survival after resection of hepatocellular carcinoma (HCC) has improved significantly over the past 20 years, even in patients with advanced disease, researchers from Hong Kong report.

The data are from 1198 consecutive patients who had HCC resected between 1989 and 2008 at Queen Mary Hospital in Hong Kong.

In the first decade, overall survival rates were 74.8% at 1 year, 54.2% at 3 years, and 42.1% at 5 years. In the second decade, by comparison, survival was 83.3% at 1 year, 64.9% at 3 years, and 54.8% at 5 years (P<.001), said Dr. Sheung Tat Fan and colleagues from The University of Hong Kong.

Recurrence rates were lower in the second decade (60.2%) than in the first (78.2%; P<.001), and disease-free survival rates were higher, the researchers report in Annals of Surgery online February 17th.

Among patients considered transplantable (but not transplanted), 5-year survival increased significantly from 62.7% in the first decade to 72.5% in the second. Disease-free survival in this group rose (nonsignificantly) from 40.2% to 49.2%.

Although disease-free survival in the transplantable patients was "far below" what could be expected after a liver transplant, "prompt treatment of recurrence detected by vigorous postoperative surveillance did result in long-term survival," the authors say.

Given the scarcity of organs for transplant, hepatectomy should be the treatment of choice in patients with resectable HCC and preserved liver function, they add.

Results were also superior in the later period when the analysis was restricted to patients undergoing major hepatectomy for TNM stage III and IV disease.

When the 20 years were divided into four 5-year sequential periods, there was a steady and significant improvement in overall and disease-free survival rates.

And this was "despite (more elderly patients), a higher incidence of comorbid illness, a higher incidence of cirrhosis, and worse liver function" in the second-decade cohort.

"Further improvement of results depends on technical refinement to reduce blood loss to the minimum, avoid blood transfusion, preserve liver remnant function, secure tumor-free resection margins, and meticulous perioperative care to reduce complications," the investigators add.

"Life-long surveillance for recurrence and prompt treatment are mandatory but development of more effective local ablation methods are needed to lengthen postrecurrence survival."

SOURCE: http://bit.ly/haCnDd

Ann Surg 2011.

 
 
 
 
                 
 
HBV
Webcasts
Slide Library
Abstract Library
 
HE
CME Dinner Meeting
Webcasts
Slide Library
Abstract Library
 
HCC
Slide Library
Abstract Library
 
 
HCV
Webcasts
Slide Library
Abstract Library
 
CLDF Follow Us
   
 
About CLDF
Mission Statement
Board of Trustees
Board of Advisors
CLDF Supporters
 
Other Resources
Liver News Library
Journal Abstracts
Hep C Link to Care
 
Centers of
Educational Expertise
Regional Map
     
   
  The Chronic Liver Disease Foundation is a non-profit organization with content developed specifically for healthcare professionals.
© Copyright 2012-2014 Chronic Liver Disease Foundation. All rights reserved. This site is maintained as an educational resource for US healthcare providers only.
Use of this Web site is governed by the Chronic Liver Disease Foundation terms of use and privacy statement.