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Hepatic resection for predominantly large size hepatocellular carcinoma: Early and long-term results from a tertiary care center in India

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

An Erratum to this article was published on 28 September 2016

Abstract

Background and Aim

There are no large series on hepatic resection for hepatocellular carcinoma (HCC) from India. We present the results of consecutive patients of HCC treated with hepatic resection at a tertiary care center in India.

Methods

The records of all patients who underwent hepatic resection for HCC in the Department of Gastrointestinal Surgery, All India Institute of Medical Sciences (New Delhi), were reviewed. The relevant perioperative and follow up data were extracted from a prospectively maintained database.

Results

Between January 1987 and December 2013, 81 patients [71 males; mean age: 49.2 ± 15.6 years] underwent hepatic resection for HCC. Of these, 23 (28 %) were cirrhotic and 36 (49 %) had hepatitis B. Hepatitis B was significantly more common in cirrhotic (77 % vs. 37 %; p = 0.001). Most patients had locally advanced disease at presentation [tumor size ≥10 cm in 61 (75 %); vascular tumor thrombus in 10 (12 %)]. Anatomical resection was done in 61 (75 %) including 56 major hepatic resections (≥3 segments). Overall in-hospital mortality was 13 (16 %) [cirrhotic 5 (22 %) vs. noncirrhotic 8 (14 %), p = 0.503]. Grade III–V complications (modified Clavien-Dindo classification) occurred in 25 (31 %) patients (cirrhotic 48 % vs. noncirrhotic 24 %; p = 0.037). Follow up information was available for 51 (75 %) patients. The median time to recurrence was 12 months, and most (86 %) occurred within 1 year. The recurrence-free survival at 1, 3, and 5 years was 48 %, 40 %, and 36 %, respectively. Positive resection margin and vascular invasion were significantly associated with very poor prognosis.

Conclusion

Majority of Indian HCC patients present with locally advanced disease. Despite this, surgical resection provides a chance for long-term recurrence-free survival in a third of them.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, 110 029, India

    Rajesh Panwar, Sujoy Pal, Nihar R Dash, Peush Sahni, Girisk K Pande, Tushar K Chattopadhyay & Samiran Nundy

  2. Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 110 029, India

    Shalimar & Subrat K Acharya

  3. Department of Surgery, Launceston General Hospital, Charles St Launceston, Tasmania, Australia

    Girisk K Pande

  4. HPB Surgery, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110 070, India

    Tushar K Chattopadhyay

  5. Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110 060, India

    Samiran Nundy

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  1. Rajesh Panwar
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  2. Sujoy Pal
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  3. Nihar R Dash
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  4. Shalimar
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  5. Peush Sahni
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  6. Subrat K Acharya
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  7. Girisk K Pande
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  8. Tushar K Chattopadhyay
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  9. Samiran Nundy
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Corresponding author

Correspondence to Rajesh Panwar.

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Conflict of interest

RP, SP, NRD, S, PS, SKA, GKP, TKC, and SN declare that they have no conflict of interest.

Ethics statement

The study was performed in a manner to conform to the 1964 Helsinki Declaration and its later amendments concerning human and animal rights, and also to the ethical standards of the institute ethics committee.

The authors followed the policy concerning informed consent as shown in Springer.com.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s12664-016-0697-1.

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Panwar, R., Pal, S., Dash, N.R. et al. Hepatic resection for predominantly large size hepatocellular carcinoma: Early and long-term results from a tertiary care center in India. Indian J Gastroenterol 35, 280–286 (2016). https://doi.org/10.1007/s12664-016-0678-4

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  • DOI: https://doi.org/10.1007/s12664-016-0678-4

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