gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Surgical therapy of hepatocellular carcinoma

Meeting Abstract

  • corresponding author presenting/speaker Süleyman Yedibela - Chirurgische Universitätsklinik Erlangen-Nürnberg, Deutschland
  • Wei Zhang - Chirurgische Universitätsklinik Erlangen-Nürnberg
  • Thomas Meyer - Chirurgische Universitätsklinik Erlangen-Nürnberg
  • Werner Hohenberger - Chirurgische Universitätsklinik Erlangen-Nürnberg

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO182

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Veröffentlicht: 20. März 2006

© 2006 Yedibela et al.
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Background: Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. We evaluated prognostic factors that could affect long-term survival and disease-free survival after surgical therapy of HCC. Moreover we compared the results after liver resection (LR) and orthotopic liver transplantation (OLT) regarding these prognostic factors.

Patients and Methods: From January 1995 to December 2004, 233 patients were evaluated for surgical therapy at the Surgical Department of University of Erlangen. There were 209 (89.7%) men and 24 (10.3%) women. Median age was 63.3 years (range 23-85 years). Hundred and thirteen patients underwent a surgical exploration. A LR or OLT was performed in 60 and 28 patients. The cohort included 31 patients without cirrhosis, 27 Child`s A, 23 Child`s B and 7 Child`s C patients.

Results: The 1-, 3-, and 5-year overall survival rates were 73.9%, 53.4% and 45.5%, respectively. The 1-, 3-, and 5-year survival rates for LR were 66.7%, 46.7% and 40%, respectively. The 1-, 3-, and 5-year survival rates for OLT were 89.3%, 67.9% and 57.1%, respectively and the difference was significant (p=0.026). Tumor grade, pre-treatment alpha-feto-protein, number of tumor nodules, lymphangial invasion, radiofrequency ablation or chemoembolization before treatment did not correlate significantly with survival and disease-free survival. Mode and extend of operation (p=0.014), tumor size >5 cm (p=0.027) and vascular invasion (p=0.024) were predictors of long-term survival. A curative resection/transplantation was performed in 80 (90%) patients. The 1-, 3-, and 5-year survival rates after curative surgical therapy were 77.5%, 57.5% and 48.8%, median survival 43 months, respectively; median survival for patients without a curative therapy was 7 month (p=0.0009). Tumor stage (UICC I (n=51), II (n=26) and III (n=11)) did not correlate significantly with survival (p=0.4227).

Conclusion: Surgical therapy – either partial LR or OLT- is the only treatment that can potentially achieve long-term survival. Patients without liver cirrhosis or Child`s A patients with tumor smaller than 5 cm maybe considered as the ideal target group for resection.