ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2015
Hepatectomy for hepatocellular carcinoma larger than 10 cm: preoperative risk stratification to prevent futile surgery.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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33 citing papers in PubMed, 59 citations in OpenAlex.
- Intensity-modulated proton therapy for patients with unresectable giant (≥ 10 cm) hepatocellular carcinoma: a retrospective analysis from two high-volume centers.Japanese journal of radiology · 2026Article
- The Differences in Clinical Outcomes for Unresectable Huge (≥ 10 cm) Hepatocellular Carcinoma With Portal Vein Thrombosis Treated by Two Different Radiotherapy Techniques.Cancer medicine · 2026Article
- Survival outcomes after surgical resection of huge HCC (≥ 10 cm) with or without neoadjuvant hepatic arterial infusion chemotherapy.World journal of surgical oncology · 2025Article
- The impacts of physical factors on huge hepatocellular carcinoma treated by transarterial chemoembolization combined with radiotherapy.Future oncology (London, England) · 2025Article
- Optimizing Outcomes in Gallbladder Cancer: Identifying Predictors of Futile Up-Front Surgery in a Global Multi-center Study.Annals of surgical oncology · 2025Article
- Article
- Seizing tumor factors for mortality and survival outcomes following liver resection in Indonesia's hepatocellular carcinoma patients.Annals of hepato-biliary-pancreatic surgery · 2025Article
- Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study.BMC gastroenterology · 2025Article
- Article
- Nomogram for predicting overall survival in patients with large (>5 cm) hepatocellular carcinoma based on real-world practice.Journal of liver cancer · 2023Article
- Development and validation of web-based prognostic nomograms for massive hepatocellular carcinoma (≥10 cm): A retrospective study based on the SEER database.Cancer medicine · 2023Article
- Association of tumor morphology with long-term prognosis after liver resection for patients with a solitary huge hepatocellular carcinoma-a multicenter propensity score matching analysis.Hepatobiliary surgery and nutrition · 2023Article
- Laparoscopic versus open hepatectomy for large hepatocellular carcinoma: a single center propensity-score-matching comparative analysis of perioperative outcomes and long-term survival.Surgical endoscopy · 2023Article
- Cirrhotic and non-cirrhotic huge hepatocellular carcinoma (≥ 10 cm): a comparative study of surgical management and follow-up treatment in a single institution.Langenbeck's archives of surgery · 2023Article
- Efficacy and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE) plus apatinib versus DEB-TACE alone in treating huge hepatocellular carcinoma patients.Irish journal of medical science · 2022Article
- Integration of Inflammation-Immune Factors to Build Prognostic Model Predictive of Prognosis and Minimal Residual Disease for Hepatocellular Carcinoma.Frontiers in oncology · 2022Article
- CT radiomics nomogram for the preoperative prediction of severe post-hepatectomy liver failure in patients with huge (≥ 10 cm) hepatocellular carcinoma.World journal of surgical oncology · 2021Article
- Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements.World journal of gastroenterology · 2021Review
- A novel preoperative predictive model of 90-day mortality after liver resection for huge hepatocellular carcinoma.Annals of translational medicine · 2021Article
- Development of a predictive nomogram for early recurrence of hepatocellular carcinoma in patients undergoing liver transplantation.Annals of translational medicine · 2021Article
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAppropriate patient selection is important to achieving good outcomes and obviating futile surgery in patients with huge (≥10 cm) hepatocellular carcinoma (HCC). The aim of this study was to identify independent predictors of futile outcomes, defined as death within 3 months of surgery or within 1 year from early recurrence following hepatectomy for huge HCC.
methodsThe outcomes of 149 patients with huge HCCs who underwent resection during 1995-2012 were analysed. Multivariate logistic regression analysis was performed to identify preoperative independent predictors of futility.
resultsIndependent predictors of 3-month mortality (18.1%) were: total bilirubin level >34 μmol/l [P = 0.0443; odds ratio (OR) 16.470]; platelet count of <150 000 cells/ml (P = 0.0098; OR 5.039), and the presence of portal vein tumour thrombosis (P = 0.0041; OR 5.138). The last of these was the sole independent predictor of 1-year recurrence-related mortality (17.2%). Rates of recurrence-related mortality at 3 months and 1 year were, respectively, 6.3% and 7.1% in patients with Barcelona Clinic Liver Cancer (BCLC) stage A disease, 12.5% and 14% in patients with BCLC stage B disease, and 37.8% (P = 0.0002) and 75% (P = 0.0002) in patients with BCLC stage C disease.
conclusionsAccording to the present data, among patients submitted to hepatectomy for huge HCC, those with a high bilirubin level, low platelet count and portal vein thrombosis are at higher risk for futile surgery. The presence of portal vein tumour thrombosis should be regarded as a relative contraindication to surgery.
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