Hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension.
<h4>Background & aims</h4>Official guidelines do not recommend hepatic resection (HR) for patients with hepatocellular carcinoma (HCC) and portal hypertension (PHT). This study aims to investigate the safety and efficacy of HR for patients with HCC and PHT.<h4>Methods</h4>...
Guardado en:
| Autores principales: | , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2014
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/5dc2de09d63a4298b451ea5c33ad5325 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:5dc2de09d63a4298b451ea5c33ad5325 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:5dc2de09d63a4298b451ea5c33ad53252021-11-25T05:58:29ZHepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension.1932-620310.1371/journal.pone.0108755https://doaj.org/article/5dc2de09d63a4298b451ea5c33ad53252014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0108755https://doaj.org/toc/1932-6203<h4>Background & aims</h4>Official guidelines do not recommend hepatic resection (HR) for patients with hepatocellular carcinoma (HCC) and portal hypertension (PHT). This study aims to investigate the safety and efficacy of HR for patients with HCC and PHT.<h4>Methods</h4>Mortality and survival after HR were analyzed retrospectively in a consecutive sample of 1738 HCC patients with PHT (n = 386) or without it (n = 1352). To assess the robustness of findings, we repeated the analysis using propensity score-matched analysis. We also comprehensively searched the PubMed database for studies evaluating the efficacy and safety of HR for patients with HCC and PHT.<h4>Results</h4>The 90-day mortality rate was 6.7% among those with PHT and 2.1% among those without it (P<.001). Patients without PHT had a survival benefit over those with PHT at 1, 3, and 5 years (96% vs 90%, 75% vs 67%, 54% vs 45%, respectively; P = .001). In contrast, PHT was not associated with worse short- or long-term survival when only propensity score-matched pairs of patients and those with early-stage HCC or those who underwent minor hepatectomy were included in the analysis (all P>.05). Moreover, the recurrence rates were similar between the two groups. Consistent with our findings, all 9 studies identified in our literature search reported HR to be safe and effective for patients with HCC and PHT.<h4>Conclusions</h4>HR is safe and effective in HCC patients with PHT and preserved liver function. This is especially true for patients who have early-stage HCC or who undergo minor hepatectomy.Jian-Hong ZhongHang LiNan XiaoXin-Ping YeYang KeYan-Yan WangLiang MaJie ChenXue-Mei YouZhi-Yuan ZhangShi-Dong LuLe-Qun LiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 9, p e108755 (2014) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Jian-Hong Zhong Hang Li Nan Xiao Xin-Ping Ye Yang Ke Yan-Yan Wang Liang Ma Jie Chen Xue-Mei You Zhi-Yuan Zhang Shi-Dong Lu Le-Qun Li Hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension. |
| description |
<h4>Background & aims</h4>Official guidelines do not recommend hepatic resection (HR) for patients with hepatocellular carcinoma (HCC) and portal hypertension (PHT). This study aims to investigate the safety and efficacy of HR for patients with HCC and PHT.<h4>Methods</h4>Mortality and survival after HR were analyzed retrospectively in a consecutive sample of 1738 HCC patients with PHT (n = 386) or without it (n = 1352). To assess the robustness of findings, we repeated the analysis using propensity score-matched analysis. We also comprehensively searched the PubMed database for studies evaluating the efficacy and safety of HR for patients with HCC and PHT.<h4>Results</h4>The 90-day mortality rate was 6.7% among those with PHT and 2.1% among those without it (P<.001). Patients without PHT had a survival benefit over those with PHT at 1, 3, and 5 years (96% vs 90%, 75% vs 67%, 54% vs 45%, respectively; P = .001). In contrast, PHT was not associated with worse short- or long-term survival when only propensity score-matched pairs of patients and those with early-stage HCC or those who underwent minor hepatectomy were included in the analysis (all P>.05). Moreover, the recurrence rates were similar between the two groups. Consistent with our findings, all 9 studies identified in our literature search reported HR to be safe and effective for patients with HCC and PHT.<h4>Conclusions</h4>HR is safe and effective in HCC patients with PHT and preserved liver function. This is especially true for patients who have early-stage HCC or who undergo minor hepatectomy. |
| format |
article |
| author |
Jian-Hong Zhong Hang Li Nan Xiao Xin-Ping Ye Yang Ke Yan-Yan Wang Liang Ma Jie Chen Xue-Mei You Zhi-Yuan Zhang Shi-Dong Lu Le-Qun Li |
| author_facet |
Jian-Hong Zhong Hang Li Nan Xiao Xin-Ping Ye Yang Ke Yan-Yan Wang Liang Ma Jie Chen Xue-Mei You Zhi-Yuan Zhang Shi-Dong Lu Le-Qun Li |
| author_sort |
Jian-Hong Zhong |
| title |
Hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension. |
| title_short |
Hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension. |
| title_full |
Hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension. |
| title_fullStr |
Hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension. |
| title_full_unstemmed |
Hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension. |
| title_sort |
hepatic resection is safe and effective for patients with hepatocellular carcinoma and portal hypertension. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2014 |
| url |
https://doaj.org/article/5dc2de09d63a4298b451ea5c33ad5325 |
| work_keys_str_mv |
AT jianhongzhong hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT hangli hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT nanxiao hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT xinpingye hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT yangke hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT yanyanwang hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT liangma hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT jiechen hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT xuemeiyou hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT zhiyuanzhang hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT shidonglu hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension AT lequnli hepaticresectionissafeandeffectiveforpatientswithhepatocellularcarcinomaandportalhypertension |
| _version_ |
1718414340653056000 |