Multi‐institutional analysis of recurrence and survival after hepatectomy for fibrolamellar carcinoma. Issue 4 (21st May 2014)

• Record Type: Journal Article
• Authors: Groeschl, Ryan T.; Miura, John T.; Wong, Ray K.; Bloomston, Mark; Lidsky, Michael L.; Clary, Bryan M.; Martin, Robert C.G.; Belli, Giulio; Buell, Joseph F.; Gamblin, T. Clark
• Is Part Of: Journal of surgical oncology. Volume 110:Issue 4(2014:Sep. 15)
• Page Start: 412
• Page End: 415
• Publication Date: 2014-05-21
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23658
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23658-sec-0001" sec-type="section"> <title>Background and Objectives</title> <p>Fibrolamellar carcinoma (FLC) presents in young, otherwise‐healthy individuals. This study examined recurrence and survival characteristics after surgical resection for FLC by utilizing an international multi‐institutional database.</p> </sec> <sec id="jso23658-sec-0002" sec-type="section"> <title>Methods</title> <p>Consecutive patients undergoing hepatectomy for FLC from six institutions (1993–2010) were reviewed retrospectively. Survival was studied with life tables and Cox regression models.</p> </sec> <sec id="jso23658-sec-0003" sec-type="section"> <title>Results</title> <p>Thirty‐five patients (13 female, 37%) were included (median age: 32 years). R0 resection was achieved in all curative‐intent operations (n = 30), and palliative operations were performed for five patients. Crude 30‐day morbidity and mortality rates were 22% and 3%, respectively. For curative‐intent surgery, overall and recurrence‐free survivals at 5 years were 62% and 45%, respectively. In patients who achieved a 4‐year disease‐free interval after surgery, none subsequently developed recurrence. In multivariate models, presence of extrahepatic disease was the only factor that independently predicted overall (hazard ratio [HR]: 5.58, 95% confidence interval [CI]: 1.38–22.55, <italic>P</italic> = 0.016) and recurrence‐free survival (HR: 5.64, 95% CI: 1.48–21.49, <italic>P</italic> = 0.011).</p> </sec> <sec id="jso23658-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Patients with surgically amenable FLC had encouraging long‐term survival. Recurrence‐free survival to 4 years suggested possible freedom from disease thereafter. Recurrent resectable disease was associated with an excellent prognosis, and repeat surgery should be strongly considered. <italic>J. Surg. Oncol. 2014; 110:412–415</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>