Short-term outcomes following hepatectomy for hepatocellular carcinoma within and beyond the BCLC guidelines: A prospective study. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Lim, Chetana; Salloum, Chady; Osseis, Michael; Lahat, Eylon; Gómez-Gavara, Concepción; Compagnon, Philippe; Luciani, Alain; Feray, Cyrille; Azoulay, Daniel
• Is Part Of: HPB. Volume 20:Issue 3(2018)
• Page Start: 222
• Page End: 230
• Publication Date: 2018-03
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2017.08.027
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Western guidelines recommend resection for hepatocellular carcinoma (HCC) in so-called ideal cirrhotic patients with a Barcelona Clinic Liver Cancer (BCLC) stage 0-A tumour. This study compares short-term outcomes following resection between patients defined as ideal and nonideal according to the BCLC guidelines. Methods: This prospective single-centre open study (ClinicalTrials.gov NCT02145013 ) included all cirrhotic patients with HCC referred for resection from 2014 to 2016. Mortality, morbidity, unresolved liver decompensation, and readmission were measured. Results: The study population included 65 consecutive patients: 32 (49%) ideal and 33 (51%) nonideal. Ideal and nonideal groups did not differ in mortality (3% vs. 6%; p = 0.57), morbidity (53% vs. 73%; p = 0.10), or unresolved liver decompensation (6% vs. 15%; p = 0.23) at 90 days. The readmission rate was higher in the nonideal (21%) than in the ideal group (3%; p = 0.02). Conclusion: Straying from the current guidelines for resection in a selected subset of nonideal patients doubled the number of resections performed for treating HCC, with satisfactory short-term outcomes. These results argue for the expansion of the acknowledged BCLC guidelines.