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Outcome of 1000 liver cancer patients evaluated at the UPMC Liver Cancer Center

  • 2005 AHPBA Annual Meeting
  • Published:
Journal of Gastrointestinal Surgery

Abstract

We evaluated 1000 consecutive patients with liver tumors at the University of Pittsburgh Medical Center (UPMC) Liver Cancer Center over the 4-year period from August 2000 to August 2004. Of the 1000 patients seen, 573 had primary liver cancer and 427 had metastatic cancer to the liver. The mean age of the patients evaluated was 62.2 years, and 61% were male. Treatment consisted of a liver surgical procedure (resection or radiofrequency ablation) in 369 cases (36.9%), hepatic intra-arterial regional therapy (transarterial chemoembolization or 90yttrium microspheres) in 524 cases (52.4%), systemic chemotherapy in 35 cases (3.5%), and palliative care in 72 patients (7.2%). For treated patients, median survival was 884 days for those undergoing resection/radiofrequency ablation, compared to 295 days with regional therapy. These data indicate that over 90% of patients with liver cancer evaluated at a tertiary referral center can be offered some form of therapy. Survival rates are superior with a liver resection or ablation procedure, which is likely consistent with selection bias. Hepatocellular carcinoma was the most common tumor seen due to referral pattern and screening of hepatitis patients at a major liver transplant center. The most common reason for offering palliative care was hepatic insufficiency usually associated with cirrhosis.

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References

  1. Bosch FX, Ribes J, Borras J. Epidemiology of primary liver cancer. Semin Liver Dis 1999;19:271–285.

    PubMed  CAS  Google Scholar 

  2. Ahn J, Flamm SL. Hepatocellular carcinoma. Dis Mon 2004; 50:556–573.

    Article  PubMed  Google Scholar 

  3. Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, Feuer EJ, Thun MJ. Cancer statistics. CA Cancer J Clin 2005;55:10–30.

    Article  PubMed  Google Scholar 

  4. Poon MA, O’Connell MJ, Moertel CG, Wieand HS, Cullinan SA, Everson LK, Krook JE, Mailliard JA, Laurie JA, Tschetter LK. Biochemical modulation of fluorouracil: evidence of significant improvement of survival and quality of life in patients with advanced colorectal carcinoma. 1989;7:1407–1418.

    CAS  Google Scholar 

  5. Song TJ, Ip EW, Fong Y. Hepatocellular carcinoma: current surgical management. Gastroenterology 2004;127:S248-S260.

    Article  PubMed  Google Scholar 

  6. Tanabe KK, Curley SA, Dodd GD, Siperstein AE, Goldberg SN. Radiofrequency ablation: the experts weigh in. Cancer 2004;100:641–650.

    Article  PubMed  Google Scholar 

  7. Ruan DT, Warren RS. Liver-directed therapies in colorectal cancer. Semin Oncol 2005;32:85–94.

    Article  PubMed  CAS  Google Scholar 

  8. Goodman M, Geller DA. Radiofrequency ablation of hepatocellular carcinoma. In: Carr B, ed. Hepatocellular Cancer. Totowa: Human Press, 2005,171–183.

    Google Scholar 

  9. Abdalla EK, Vauthey JN, Ellis LM, Ellis V, Pollock R, Broglio KR, Hess K, Curley SA. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 2004;239:818–825.

    Article  PubMed  Google Scholar 

  10. Carr BI. Hepatocellular carcinoma: current management and future trends. Gastroenterology 2004;127:S218-S224.

    Article  PubMed  Google Scholar 

  11. Ebied OM, Federle MP, Carr BI, Pealer KM, Li W, Amesur N, Zajko A. Evaluation of responses to chemoemoblization in patients with unresectable hepatocellular carcinoma. Cancer 2003;97:1042–1050.

    Article  PubMed  Google Scholar 

  12. Bruix J, Sala M, Llovet JM. Chemoembolization for hepatocellular carcinoma. Gastroenterology 2004;127:S179-S188.

    Article  PubMed  CAS  Google Scholar 

  13. Carr BI. Hepatic arterychemoembolization for advanced stage HCC: experience of 650 patients. Hepatogastroenterology 2002;49:79–86.

    PubMed  CAS  Google Scholar 

  14. Carr BI. Hepatic arterial 90Yttrium glass microspheres (Therasphere) for unresectable hepatocellular carcinoma: interim safety and survival data on 65 patients. Liver Transpl 2004;10:S107-S110.

    Article  PubMed  Google Scholar 

  15. Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT, Fan ST, Wong J. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002;35:1164–1171.

    Article  PubMed  CAS  Google Scholar 

  16. Llovet JM, Real MI, Montana X, Planas R, Coll S, Aponte J, Ayuso C, Sala M, Muchart J, Sola R, Rodes J, Bruix J. Barcelona Liver Cancer Group. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002;359:1734–1739.

    Article  PubMed  Google Scholar 

  17. Marsh JW, Geller DA, Finkelstein SD, Donaldson JB, Dvorchik I. The role of liver transplantation for hepatobiliary malignancy. Lancet Oncol 2004;5:480–508.

    Article  PubMed  Google Scholar 

  18. Marsh JW, Finkelstein SD, Schwartz ME, Fiel MI, Dvorchik I. Advancing the diagnosis and treatment of hepatocellular carcinoma. Liver Transpl 2005;11:469–472.

    Article  PubMed  Google Scholar 

  19. Roayaie S, Schwartz JD, Sung MW, Emre SH, Miller CM, Gondolesi GE, Krieger NR, Schwartz ME. Recurrence of hepatocellular carcinoma after liver transplant: patterns and prognosis. Liver Transpl 2004;10:534–540.

    Article  PubMed  Google Scholar 

  20. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. NEJM 1999;340:745–750.

    Article  PubMed  CAS  Google Scholar 

  21. Rutstein L, Geller DA. Hepatocellular carcinoma. In: Mclntyre R, ed. Surgical Decision Making 5th ed. Philadelphia: Elsevier Science, 2004, pp 174–179.

    Google Scholar 

  22. Carr BI, Marsh JW, Geller DA. Putting it all together: practical guidelines and considerations for physicians. In: Carr B, ed. Hepatocellular Cancer. Totawa: Human Press, 2005, pp 285–291.

    Google Scholar 

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Correspondence to David A. Geller M.D..

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Supported by grant NIH R01-GM52021 (DAG).

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Geller, D.A., Tsung, A., Marsh, J.W. et al. Outcome of 1000 liver cancer patients evaluated at the UPMC Liver Cancer Center. J Gastrointest Surg 10, 63–68 (2006). https://doi.org/10.1016/j.gassur.2005.06.032

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  • DOI: https://doi.org/10.1016/j.gassur.2005.06.032

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