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First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).
Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.
Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.
Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016. Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450). Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.
First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).
Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.
Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.
Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016. Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450). Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.
First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).
Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.
Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.
Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016. Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450). Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.