Prognostic benefit of selective portal vein occlusion during hepatic resection for hepatocellular carcinoma.

Abstract:

BACKGROUND:The aim of this study was to clarify whether the types of portal vein (PV) occlusion during hepatectomy affect the long-term outcome in patients with hepatocellular carcinoma (HCC). METHODS:Eighty-six patients who had undergone curative hepatic resection for HCC were divided on the basis of the type of PV occlusion into 2 groups: total PV occlusion (TPVO, n = 56) and selective PV occlusion (SPVO, n = 30) groups. The recurrence-free survival was compared between the groups, and factors affecting recurrence-free survival were examined by univariate analyses followed by multivariate analyses. Moreover, the patients with a single nodular HCC less than 5 cm in diameter were abstracted from both groups, and the recurrence-free survival rate was compared. RESULTS:The patients and tumor-related factors were similar in the TPVO and SPVO groups. The recurrence-free survival was better in the SPVO group than in the TPVO group (median recurrence-free survival time, 1520 vs 561 days, P = .017). The type of PV occlusion was a significant factor for recurrence-free survival by univariate analysis but did not reach significance ( P = .052) by multivariate analysis. In the selected patients who had a single nodular HCC less than 5 cm in diameter, the recurrence-free survival was also significantly better in the SPVO group than in the TPVO group (median recurrence-free survival time, 2613 vs 1003 days, P = .018). CONCLUSIONS:Hepatectomy under selective PV occlusion seems to improve the recurrence-free survival in patients with HCC.

journal_name

Surgery

journal_title

Surgery

authors

Makino I,Chijiiwa K,Kondo K,Ohuchida J,Kai M

doi

10.1016/j.surg.2005.02.008

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

626-31

issue

6

eissn

0039-6060

issn

1532-7361

pii

S0039606005000851

journal_volume

137

pub_type

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