The role of liver resection in patients with intermediate and advanced stage hepatocellular carcinoma. Retrospective study from two Greek HPB centers

Abstract

Background: The indications for liver resection in patients with intermediate (BCLC B: single tumor >5 cm or multiple tumors >3 cm each) or advanced stage (BCLC C: presence of macrovascular thrombosis) hepatocellular carcinoma (HCC) are not clear yet. Liver resection is not recommended for this group of patients in the European and the American Association for the Study of Liver Disease guidelines. The aim of this retrospective study was to present the experience of two Greek HPB centers in the surgical management of patients with HCC. Methods: Data from patients with HCC who underwent surgical resection from 01.01.2007 till 30.06.2016 were analyzed. Results: 70 patients were included in the study, with a median age of 69 yrs (range: 21-82). There were 54 male and 16 female patients. The majority of the patients developed HCC on a background of liver cirrhosis (59%) and the most common causes were alcoholic liver disease (ALD) (39%), Hepatitis B (HBV) infection (31%) and hepatic steatosis (23%). The majority of the patients (38/70, 54%) were in intermediate or advanced stage. The 90-day mortality rate was 0. The overall morbidity was 39%. The 1-, 3- and 5yrs overall survival was 89%, 60% and 40 % for all patients and 82%, 50% and 39 % for the patients with BCLC B and BCLC C stage HCC. Conclusion: This study shows that liver resection has a clear role in the management of patients with non-early HCC as is was used widely with acceptable short and long term Results.