Prognostic Factors and Outcomes after Liver Resection for Hepatocellular Carcinoma in Non-Cirrhotic, Non-Fibrotic Liver
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
Background: Hepatocellular carcinoma (HCC) is a major health burden and its incidence is increasing globally.Numerous publications have addressed the prognostic factors and long-term survival after liver resection for HCC, but most of these studies have included patients with and without cirrhosis. The aim of the present study is to identify predictive factors and survival outcome after liver resection for non-cirrhotic HCC. Methods: This is a retrospective analysis of prospectively collected data between January 2011 and December 2015.Of the 76 patients who had liver resections for HCC, 30 patients had no underlying parenchymal liver disease (no cirrhosis or fibrosis) and these 30 patients were included in the study. Results: Out of 30 patients, 25 patients (83%) underwent major hepatectomy whereas only 5 patients (17%) underwent minor hepatectomy. The overall 1-, 2-, 3- year survival rates were 86.7%, 66.7% and 63.3% respectively.In the univariate analysis, high-grade tumor, prothrombin time and serum bilirubin level were significant predictors of poor long-term survival. In the multivariate analysis, only high-grade tumor was identified as independent prognostic factor for overall survival. The overall 1-, 2-, 3- year disease-free survivals were 66.6%, 53.3% and 50% respectively. In the univariate analysis, need for blood transfusion, post-operative liver failure, wound infection, sepsis, high-grade tumor, vascular invasion, prothrombin time, serum bilirubin, post-operative length of stay significantly affected the disease-free survival. The multivariate analysis identified high-grade tumors, vascular invasion, and sepsis as independent prognostic factors for disease free survival after liver resection for non-cirrhotic HCC patients. Conclusion: Vascular invasion, tumor differentiation and sepsis are identified as poor prognostic factors after liver resection in patients with non-cirrhotic HCC. The presence of these poor prognostic factors in noncirrhotic HCC patients necessitates a stringent follow-up to detect and treat recurrence.
Authors and Affiliations
Satish Devakumar Murugesan, SrinivasanUlagendra Perumal, Senthilkumar Perumal, Jeswanth Sathyanesan, Ravichandran Palaniappan, Surendran Rajagopalan
Keywords
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- EP ID EP467636
- DOI 10.9790/0853-1802114353.
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