TY - JOUR
T1 - Hepatocellular carcinoma
T2 - Multimodality management
AU - Christians, Kathleen K.
AU - Pitt, Henry A.
AU - Rilling, William S.
AU - Franco, Jose
AU - Quiroz, Francisco A.
AU - Adams, Mark B.
AU - Wallace, James R.
AU - Quebbeman, Edward J.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2001
Y1 - 2001
N2 - Background. Hepatocellular carcinoma is one of the most common tumors worldwide. Surgical resection has been the standard treatment but can only be applied to a small percentage of patients. In recent years, several other treatment options, including ablative procedures and transplantation, have been used in patients with hepatocellular carcinoma. Methods. For 6 Years, 110 patients with hepatocellular carcinoma were managed at the Medical College of Wisconsin. Fifty-five patients received only chemotherapy (n = 5) or palliative treatment (n = 50) because of advanced cirrhosis (P<.03) or tumor. Thirty-one patients had tumor ablation with percutaneous ethanol injection, cryoablation, radiofrequency ablation, or arterial chemoembolization. Twenty-eight patients underwent surgical resection (n = 18) or hepatic transplantation (n = 10). Relatively more patients (38%; P<.001) were treated with ablation in the second period of the study (1998-2000). Results. Thirty-day mortality was 3% with ablation and 0% with resection. Median survival was 6 months with no treatment, 27 months with ablation (P<.001), and 35 months with resection (P<001). Patients who underwent liver transplantation had the longest median survival (53 months). A multivariate analysis suggested that treatment modality (ablation or resection; P<.001) and Child-Pugh classification (P<.01) were the most important factors predicting outcome. Conclusions. This study suggests that treatment of hepatocellular carcinoma requires multidisciplinary expertise and that ablation and operation can be performed safely. Outcome is influenced most by treatment modality and Child-Pugh classification. Patients in Child-Pugh classes A and B should be treated with ablation, surgical resection, or liver transplantation.
AB - Background. Hepatocellular carcinoma is one of the most common tumors worldwide. Surgical resection has been the standard treatment but can only be applied to a small percentage of patients. In recent years, several other treatment options, including ablative procedures and transplantation, have been used in patients with hepatocellular carcinoma. Methods. For 6 Years, 110 patients with hepatocellular carcinoma were managed at the Medical College of Wisconsin. Fifty-five patients received only chemotherapy (n = 5) or palliative treatment (n = 50) because of advanced cirrhosis (P<.03) or tumor. Thirty-one patients had tumor ablation with percutaneous ethanol injection, cryoablation, radiofrequency ablation, or arterial chemoembolization. Twenty-eight patients underwent surgical resection (n = 18) or hepatic transplantation (n = 10). Relatively more patients (38%; P<.001) were treated with ablation in the second period of the study (1998-2000). Results. Thirty-day mortality was 3% with ablation and 0% with resection. Median survival was 6 months with no treatment, 27 months with ablation (P<.001), and 35 months with resection (P<001). Patients who underwent liver transplantation had the longest median survival (53 months). A multivariate analysis suggested that treatment modality (ablation or resection; P<.001) and Child-Pugh classification (P<.01) were the most important factors predicting outcome. Conclusions. This study suggests that treatment of hepatocellular carcinoma requires multidisciplinary expertise and that ablation and operation can be performed safely. Outcome is influenced most by treatment modality and Child-Pugh classification. Patients in Child-Pugh classes A and B should be treated with ablation, surgical resection, or liver transplantation.
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U2 - 10.1067/msy.2001.117106
DO - 10.1067/msy.2001.117106
M3 - Article
C2 - 11602884
AN - SCOPUS:0034788280
VL - 130
SP - 554
EP - 560
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 4
M1 - 04217
ER -