1887

n South African Journal of Surgery - Liver resection for non-cirrhotic hepatocellular carcinoma in South African patients : general surgery

USD

 

Abstract

. We describe the clinicopathologic features and outcome of South African patients who have undergone hepatic resection for hepatocellular carcinoma (HCC) arising in a non-cirrhotic liver.


. We utilised the prospective liver resection database in the Surgical Gastroenterology Unit at Groote Schuur Hospital, Cape Town, to identify all patients who underwent surgery for HCC with non-cirrhotic liver parenchyma between 1990 and 2008.
. Twenty-two patients (10 men, 12 women, 3 black, 19 white, median age 47 years, range 21 - 79 years) underwent surgery for non-cirrhotic HCC. Sixteen patients had non-fibrolamellar HCC (Group 1); 6 patients had fibrolamellar HCC (Group 2). Group 1 had a median age of 55 years, and 6 (38%) were men; group 2 had a median age of 21 years, and 5 (83%) were men. Most patients had a solitary tumour at diagnosis; median largest tumour diameters in Groups 1 and 2 were 10 cm (range 4 - 21) and 12 cm (range 4 - 17), respectively. Patients in Group 1 underwent extended right hepatectomy (=3), right hepatectomy (=3), left hepatectomy (=3), partial hepatectomy (=7), cholecystectomy (=6), and appendicectomy (=1). Patients in Group 2 underwent extended right hepatectomy (=1), right hepatectomy (=1), left hepatectomy (=2), segmentectomy (=2), and portal lymphadenectomy (=3). Recurrence rates in Groups 1, 2, and overall were 81%, 100% and 86%, respectively. Median overall survival was 46 months, with 1-, 3-, and 5-year survival rates of 95%, 59% and 45%, respectively. In Group 1, median survival was 39 months, with 1-, 3-, and 5-year survival rates of 100%, 56% and 38% respectively. In Group 2, median survival was 61 months, with 1-, 3-, and 5-year survival rates of 83%, 67% and 67%, respectively.
. Despite aggressive surgical resection, HCC arising in normal liver parenchyma has a high recurrence rate and an ultimately poor outcome. This finding is similar to both the recent international experience of non-cirrhotic HCC and local experience of fibrolamellar HCC.

Loading

Article metrics loading...

/content/m_sajs/49/2/EJC66861
2011-03-01
2016-12-08
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error