ArticleJHEP reports : innovation in hepatology2021
Liver resection for hepatocellular carcinoma in patients with clinically significant portal hypertension.
Article in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 4 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 4 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- The "Textbook Outcome" Isn't Textbook: Significant Variation in "Textbook Outcome" Definitions following a Systematic Review of the Surgical Oncology Literature.Annals of surgical oncology · 2026Pooled it
- Guideline
- Textbook Outcomes in Liver Surgery: a Systematic Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- Pooled it
- Cirrhosis, portal hypertension and hepatocellular carcinoma: a stage-based approach.Nature reviews. Gastroenterology & hepatology · 2026Review
- Refining the role of liver transplantation as a curative treatment for hepatocellular carcinoma.International journal of clinical oncology · 2026Review
- Risk factors for posthepatectomy liver failure: a secondary analysis of prospective clinical trials.Langenbeck's archives of surgery · 2026Article
- Transcatheter arterial chemoembolization plus ablation therapy versus liver resection for hepatocellular carcinoma with clinically significant portal hypertension by an inverse probability of treatment weighting analysis.Updates in surgery · 2026Article
- ASO Author Reflections: Liver Resection for Hepatocellular Carcinoma with Clinically Significant Portal Hypertension: Reflections on Past Debates, Present Evidence, and Future Directions.Annals of surgical oncology · 2026Article
- Improving surgical treatments for hepatocellular carcinoma.Nature reviews. Gastroenterology & hepatology · 2026Review
- Identifying the Optimal Treatment for Patients with Hepatocellular Carcinoma and Clinically Significant Portal Hypertension: A Multicenter Propensity Score-Weighted Analysis.Annals of surgical oncology · 2026Article
- Impact of clinically significant portal hypertension on posthepatectomy liver failure: A systematic review and meta-analysis.World journal of hepatology · 2026Article
- Role of Liver Function in the Multiparametric Assessment of Hepatocellular Carcinoma.Medicina (Kaunas, Lithuania) · 2026Review
- The Evolving Landscape of Hepatocellular Carcinoma Therapy: From Conventional Modalities to TME-Responsive Prodrug Design Strategies.Drug design, development and therapy · 2026Review
- Resection in HCC and cirrhosis: linking clinical relevance to improved outcomes.Hepatology international · 2025Article
- Response to: "Refining Surgical Indications for Hepatocellular Carcinoma in Patients with Clinically Significant Portal Hypertension".Hepatology international · 2025Article
- Robotic vs laparoscopic resection for hepatocellular carcinoma: multicentric propensity-score matched analysis of surgical and oncologic outcomes in 647 patients.Updates in surgery · 2025Article
- Modern approach to hepatocellular carcinoma treatment.World journal of hepatology · 2025Review
- Transjugular diagnostic procedures in hepatology: Indications, techniques and interpretation.JHEP reports : innovation in hepatology · 2025Review
- Assessing the Validity of the AASLD Surgical Treatment Algorithm in Patients with Early-Stage Hepatocellular Carcinoma.Gut and liver · 2025Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsLiver resection (LR) in patients with hepatocellular carcinoma (HCC) and clinically significant portal hypertension (CSPH) defined as a hepatic venous pressure gradient (HVPG) ≥10 mmHg is not encouraged. Here, we reappraised the outcomes of patients with cirrhosis and CSPH who underwent LR for HCC in highly specialised liver centres.
methodsThis was a retrospective multicentre study from 1999 to 2019. Predictors for postoperative liver decompensation and textbook outcomes were identified.
resultsIn total, 79 patients with a median age of 65 years were included. The Child-Pugh grade was A in 99% of patients, and the median model for end-stage liver disease (MELD) score was 8. The median HVPG was 12 mmHg. Major hepatectomies and laparoscopies were performed in 28% and 34% of patients, respectively. Ninety-day mortality and severe morbidity rates were 6% and 27%, respectively. Postoperative and persistent liver decompensation occurred in 35% and 10% of patients at 3 months. Predictors of liver decompensation included increased preoperative HVPG (
conclusionsPatients with cirrhosis, HCC and HVPG ≥10 mmHg can undergo LR with acceptable mortality, morbidity, and liver decompensation rates. The laparoscopic approach was the sole predictor of a textbook outcome. LAY SUMMARY: Patients with cirrhosis, hepatocellular carcinoma, and clinically significant portal hypertension (defined as a hepatic venous pressure gradient ≥10 mmHg) can undergo resection with acceptable mortality, morbidity, liver decompensation rates, and a textbook outcome. These results can be achieved in selected patients with preserved liver function, good general status, and sufficient remnant liver volume.
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