World Journal of Surgery

, Volume 35, Issue 5, pp 1055–1062

Resection of a Transplantable Single-Nodule Hepatocellular Carcinoma in Child-Pugh Class A Cirrhosis: Factors Affecting Survival and Recurrence

  • Fabrice Muscari
  • Bertrand Foppa
  • Nicolas Carrere
  • Nassim Kamar
  • Jean-Marie Peron
  • Bertrand Suc
Article

DOI: 10.1007/s00268-011-1000-3

Cite this article as:
Muscari, F., Foppa, B., Carrere, N. et al. World J Surg (2011) 35: 1055. doi:10.1007/s00268-011-1000-3

Abstract

Background

The aim of this study was to estimate the survival rates and define risk factors for tumor recurrence after resection surgery for single hepatocellular carcinomas (HCCs) ≤5 cm (on preoperative imaging) that developed on compensated cirrhosis.

Methods

A retrospective review studied patients treated by surgical resection. Overall survival (OS), disease-free survival (DFS), recurrence rates, and risk factors were studied for all patients.

Results

A total of 49 patients were treated by resection. The 5-year OS and DFS rates were 52 and 41%, respectively, after 2000. Three independent risk factors were found for OS and DFS: macroscopic vascular invasion, satellite nodules, R1 resection. In the absence of these three factors, the 5-year OS was 59%. Recurrence rates were 63%. Delayed recurrence was significantly related to the 5-year OS. One factor was correlated with early recurrence: the presence of satellite nodules; and one factor was correlated with late recurrence: hepatitis C virus infection.

Conclusions

R0 resection for HCC on compensated cirrhosis may offer good long-term survival in the absence of satellites nodules and macrovascular invasion. Thus, a “first approach” resection is proposed with the possibility of “salvage transplantation.” In other cases, resection may be a bridge to transplantation (“transplantation de principe”).

Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Fabrice Muscari
    • 1
    • 2
    • 6
  • Bertrand Foppa
    • 1
  • Nicolas Carrere
    • 3
  • Nassim Kamar
    • 4
  • Jean-Marie Peron
    • 5
  • Bertrand Suc
    • 1
  1. 1.Liver Transplantation and Digestive Surgery UnitUniversity Hospital of RangueilToulouseFrance
  2. 2.Epidemiology and Inserm U1027 LaboratoryToulouseFrance
  3. 3.Digestive Surgery UnitUniversity Hospital of PurpanToulouseFrance
  4. 4.Organ Transplantation and Nephrology UnitUniversity Hospital of RangueilToulouseFrance
  5. 5.Hepatology UnitUniversity Hospital of PurpanToulouseFrance
  6. 6.Service de Chirurgie Digestive et Transplantation Hépatique, CHU RangueilToulouse Cedex 9France