Resection Prior to Liver Transplantation for Hepatocellular Carcinoma

Objective: To evaluate the feasibility and postoperative course of liver transplantation (LT) in cirrhotic patients who underwent liver resection prior to LT for HCC. Summary Background Data: Although LT provides longer survival than liver resection for treatment of small HCCs, donor shortage and lo...

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التفاصيل البيبلوغرافية
المؤلف الرئيسي: Belghiti, Jacques (author)
مؤلفون آخرون: Cortes, Alexandre (author), Abdalla, Eddie (author), Regimbeau, Jean-Marc (author), Prakash, Kurumboor (author), Durand, Francois (author), Sommacale, Daniele (author), Dondero, Federica (author), Lesurtel, Mickeal (author), Sauvanet, Alain (author), Farges, Olivier (author), Kianmanesh, Reza (author)
التنسيق: article
منشور في: 2003
الوصول للمادة أونلاين:http://hdl.handle.net/10725/2514
http://dx.doi.org/10.1097/01.sla.0000098621.74851.65
http://journals.lww.com/annalsofsurgery/Abstract/2003/12000/Resection_Prior_to_Liver_Transplantation_for.12.aspx
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author Belghiti, Jacques
author2 Cortes, Alexandre
Abdalla, Eddie
Regimbeau, Jean-Marc
Prakash, Kurumboor
Durand, Francois
Sommacale, Daniele
Dondero, Federica
Lesurtel, Mickeal
Sauvanet, Alain
Farges, Olivier
Kianmanesh, Reza
author2_role author
author
author
author
author
author
author
author
author
author
author
author_facet Belghiti, Jacques
Cortes, Alexandre
Abdalla, Eddie
Regimbeau, Jean-Marc
Prakash, Kurumboor
Durand, Francois
Sommacale, Daniele
Dondero, Federica
Lesurtel, Mickeal
Sauvanet, Alain
Farges, Olivier
Kianmanesh, Reza
author_role author
dc.creator.none.fl_str_mv Belghiti, Jacques
Cortes, Alexandre
Abdalla, Eddie
Regimbeau, Jean-Marc
Prakash, Kurumboor
Durand, Francois
Sommacale, Daniele
Dondero, Federica
Lesurtel, Mickeal
Sauvanet, Alain
Farges, Olivier
Kianmanesh, Reza
dc.date.none.fl_str_mv 2003
2015-11-10T12:43:55Z
2015-11-10T12:43:55Z
2015-11-10
dc.identifier.none.fl_str_mv 0003-4932
http://hdl.handle.net/10725/2514
http://dx.doi.org/10.1097/01.sla.0000098621.74851.65
Belghiti, J., Cortes, A., Abdalla, E. K., Régimbeau, J. M., Prakash, K., Durand, F., ... & Kianmanesh, R. (2003). Resection prior to liver transplantation for hepatocellular carcinoma. Annals of surgery, 238(6), 885.
http://journals.lww.com/annalsofsurgery/Abstract/2003/12000/Resection_Prior_to_Liver_Transplantation_for.12.aspx
dc.language.none.fl_str_mv en
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Objective: To evaluate the feasibility and postoperative course of liver transplantation (LT) in cirrhotic patients who underwent liver resection prior to LT for HCC. Summary Background Data: Although LT provides longer survival than liver resection for treatment of small HCCs, donor shortage and long LT wait time may argue against LT. The feasibility and survival following LT after hepatic resection have not been previously examined. Methods: Between 1991 and 2001, among 107 patients who underwent LT for HCC, 88 met Mazzafero’s criteria upon pathologic analysis of the explant. Of these, 70 underwent primary liver transplantation (PLT) and 18 liver resection prior to secondary liver transplantation (SLT) for recurrence (n = 11), deterioration of liver function (n = 4), or high risk for recurrence (n = 3). Perioperative and postoperative factors and long-term survival were compared. Results: Comparison of PLT and SLT groups at the time of LT revealed similar median age (53 vs. 55 years), sex, and etiology of liver disease (alcohol/viral B/C/other). In the SLT group, the mean time between liver resection and listing for LT was 20 months (range 1–84 months). Overall time on LT waiting list of the two groups was similar (3 vs. 5 months). Pathologic analysis after LT revealed similar tumor size (2.2 vs. 2.3 cm) and number (1.6 vs. 1.7). Perioperative and postoperative courses were not different in terms of operative time (551 vs. 530 minutes), blood loss (1191 vs. 1282 mL), transfusion (3 vs. 2 units), ICU (9 vs. 10 days) or hospital stay (32 vs. 31 days), morbidity (51% vs. 56%) or 30-day mortality (5.7% vs. 5.6%). During a median follow-up of 32 months (3 to 158 months), 3 patients recurred after PLT and one after SLT. After transplantation, 3- and 5-year overall survivals were not different between groups (82 vs. 82% and 59 vs. 61%). Conclusions: In selected patients, liver resection prior to transplantation does not increase the morbidity or impair long-term survival following LT. Therefore, liver resection prior to transplantation can be integrated in the treatment strategy for HCC.
eu_rights_str_mv openAccess
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identifier_str_mv 0003-4932
Belghiti, J., Cortes, A., Abdalla, E. K., Régimbeau, J. M., Prakash, K., Durand, F., ... & Kianmanesh, R. (2003). Resection prior to liver transplantation for hepatocellular carcinoma. Annals of surgery, 238(6), 885.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
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publishDate 2003
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spelling Resection Prior to Liver Transplantation for Hepatocellular CarcinomaBelghiti, JacquesCortes, AlexandreAbdalla, EddieRegimbeau, Jean-MarcPrakash, KurumboorDurand, FrancoisSommacale, DanieleDondero, FedericaLesurtel, MickealSauvanet, AlainFarges, OlivierKianmanesh, RezaObjective: To evaluate the feasibility and postoperative course of liver transplantation (LT) in cirrhotic patients who underwent liver resection prior to LT for HCC. Summary Background Data: Although LT provides longer survival than liver resection for treatment of small HCCs, donor shortage and long LT wait time may argue against LT. The feasibility and survival following LT after hepatic resection have not been previously examined. Methods: Between 1991 and 2001, among 107 patients who underwent LT for HCC, 88 met Mazzafero’s criteria upon pathologic analysis of the explant. Of these, 70 underwent primary liver transplantation (PLT) and 18 liver resection prior to secondary liver transplantation (SLT) for recurrence (n = 11), deterioration of liver function (n = 4), or high risk for recurrence (n = 3). Perioperative and postoperative factors and long-term survival were compared. Results: Comparison of PLT and SLT groups at the time of LT revealed similar median age (53 vs. 55 years), sex, and etiology of liver disease (alcohol/viral B/C/other). In the SLT group, the mean time between liver resection and listing for LT was 20 months (range 1–84 months). Overall time on LT waiting list of the two groups was similar (3 vs. 5 months). Pathologic analysis after LT revealed similar tumor size (2.2 vs. 2.3 cm) and number (1.6 vs. 1.7). Perioperative and postoperative courses were not different in terms of operative time (551 vs. 530 minutes), blood loss (1191 vs. 1282 mL), transfusion (3 vs. 2 units), ICU (9 vs. 10 days) or hospital stay (32 vs. 31 days), morbidity (51% vs. 56%) or 30-day mortality (5.7% vs. 5.6%). During a median follow-up of 32 months (3 to 158 months), 3 patients recurred after PLT and one after SLT. After transplantation, 3- and 5-year overall survivals were not different between groups (82 vs. 82% and 59 vs. 61%). Conclusions: In selected patients, liver resection prior to transplantation does not increase the morbidity or impair long-term survival following LT. Therefore, liver resection prior to transplantation can be integrated in the treatment strategy for HCC.PublishedN/A2015-11-10T12:43:55Z2015-11-10T12:43:55Z20032015-11-10Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0003-4932http://hdl.handle.net/10725/2514http://dx.doi.org/10.1097/01.sla.0000098621.74851.65Belghiti, J., Cortes, A., Abdalla, E. K., Régimbeau, J. M., Prakash, K., Durand, F., ... & Kianmanesh, R. (2003). Resection prior to liver transplantation for hepatocellular carcinoma. Annals of surgery, 238(6), 885.http://journals.lww.com/annalsofsurgery/Abstract/2003/12000/Resection_Prior_to_Liver_Transplantation_for.12.aspxeninfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/25142019-02-26T10:55:40Z
spellingShingle Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
Belghiti, Jacques
status_str publishedVersion
title Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
title_full Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
title_fullStr Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
title_full_unstemmed Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
title_short Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
title_sort Resection Prior to Liver Transplantation for Hepatocellular Carcinoma
url http://hdl.handle.net/10725/2514
http://dx.doi.org/10.1097/01.sla.0000098621.74851.65
http://journals.lww.com/annalsofsurgery/Abstract/2003/12000/Resection_Prior_to_Liver_Transplantation_for.12.aspx