World Journal of Surgery

, Volume 35, Issue 4, pp 834–841 | Cite as

Selection Criteria for Hepatectomy in Patients with Hepatocellular Carcinoma Classified as Child-Pugh Class B

  • Shintaro Kuroda
  • Hirotaka TashiroEmail author
  • Tsuyoshi Kobayashi
  • Akihiko Oshita
  • Hironobu Amano
  • Hideki Ohdan



The appropriate surgical approach for hepatocellular carcinoma (HCC) patients of Child-Pugh class B is unclear. The aim of this study was to clarify the prognostic factors after hepatectomy in Child-Pugh class B patients and to delineate the selection criteria for hepatectomy.


One hundred fifty patients of Child-Pugh class B who underwent hepatectomy were enrolled in this retrospective study (Hx group). Univariate and multivariate analyses were performed to identify prognostic factors. The prognosis was compared with that of 23 patients of Child-Pugh class B who underwent liver transplantation (LT group).


The overall survival rate of the Hx group was significantly worse than that of the LT group (5-year survival: 36.0 vs. 78.3%, p = 0.001). In multivariate analyses, diabetes mellitus (p = 0.011), preoperative total bilirubin level ≥1.5 mg/dl (p = 0.038), and Child-Pugh score of 8 or 9 (p = 0.038) were independent prognostic factors. Although the overall 5-year survival rate of patients with none of the three adverse prognostic factors was only 50.3%, that of patients with one or more adverse prognostic factors was only 27.2% (p = 0.001).


Hepatectomy may be the optimal initial treatment for HCC patients classified as Child-Pugh class B and without any adverse prognostic factors.


Liver Transplantation Liver Cirrhosis Esophageal Varix Milan Criterion Adverse Prognostic Factor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Shintaro Kuroda
    • 1
  • Hirotaka Tashiro
    • 1
    Email author
  • Tsuyoshi Kobayashi
    • 1
  • Akihiko Oshita
    • 1
  • Hironobu Amano
    • 1
  • Hideki Ohdan
    • 1
  1. 1.Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan

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