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Comparison of hepatic resection and hepatic transplantation in the treatment of hepatocellular carcinoma among cirrhotic patients

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Abstract

Background

The benefits of hepatic transplantation (HT) compared with hepatic resection (HR) in treating hepatocellular carcinoma (HCC) in patients with cirrhosis are controversial. The aim of this study was to compare the results of these therapeutic options.

Methods

The charts of all patients with cirrhosis who underwent HR or HT for HCC between 1997 and 2000 were analyzed.

Results

The cohort included 44 patients who underwent HR compared with 65 with HT. All patients in the HR group had Child's A disease, in contrast to the HT group, which included 23% Child's A and 77% Child's B and C patients. Whereas all HT patients spent at least three nights in the intensive care unit, 41% of the HR group never required critical care. Perioperative mortality was 7% in both groups. Pathologic analysis revealed T1/T2 disease in 43% of the HR group compared with 75% of the HT group. After 36 months of follow-up, there was no significant difference in overall survival (57% vs. 66%) or disease-free survival (36% vs. 66%) between the two groups.

Conclusions

With overall survival and disease-free survival as the main outcomes, the results of HR versus HT are comparable in Child's A patients with HCC. In this patient subset, HR not only is an effective form of therapy, but is also associated with quicker recovery.

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Authors and Affiliations

  1. Divisions of Surgical Oncology (Department of Surgery), University of Miami School of Medicine, Miami, Florida

    Mohsen Shabahang MD, PhD, Dido Franceschi MD, Peter A. Pappas MD, Kuky Aviles MD, Sonia Flores MD, Andrea Chaparro MD, Joseph U. Levi MD, Danny Sleeman MD & Alan S. Livingstone MD

  2. Transplantation (Department of Surgery), University of Miami School of Medicine, Miami, Florida

    Andreas G. Tzakis MD, Tomoaki Kato MD & David M. Levi MD

  3. Gastroenterology (Department of Medicine), University of Miami School of Medicine, Miami, Florida

    Noriyo Yamashiki MD & Raj Reddy MD

Authors
  1. Mohsen Shabahang MD, PhD
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  2. Dido Franceschi MD
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  3. Noriyo Yamashiki MD
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  4. Raj Reddy MD
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  5. Peter A. Pappas MD
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  6. Kuky Aviles MD
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  7. Sonia Flores MD
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  8. Andrea Chaparro MD
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  9. Joseph U. Levi MD
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  10. Danny Sleeman MD
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  11. Andreas G. Tzakis MD
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  12. Tomoaki Kato MD
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  13. David M. Levi MD
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  14. Alan S. Livingstone MD
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Corresponding author

Correspondence to Mohsen Shabahang MD, PhD.

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Shabahang, M., Franceschi, D., Yamashiki, N. et al. Comparison of hepatic resection and hepatic transplantation in the treatment of hepatocellular carcinoma among cirrhotic patients. Annals of Surgical Oncology 9, 881–886 (2002). https://doi.org/10.1007/BF02557525

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  • DOI: https://doi.org/10.1007/BF02557525

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