Details

Autor(en) / Beteiligte

• Witjes, Carlijn D M
• de Man, Robert A
• Eskens, Ferry A L M
• Dwarkasing, Roy S
• Zondervan, Pieter E
• Verhoef, Cornelis
• Ijzermans, Jan N M

Titel

Hepatocellular carcinoma: the significance of cirrhosis for treatment and prognosis--retrospective study

Ist Teil von

• Nederlands tijdschrift voor geneeskunde, 2010, Vol.154, p.A1747

Ort / Verlag

Netherlands

Erscheinungsjahr

2010

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• To determine whether the presence of liver cirrhosis was related to the treatment options and survival of patients with hepatocellular carcinoma (HCC). Retrospective. A status investigation of all HCC patients who were treated in the period 2000-2007 at the Erasmus MC Hospital, Rotterdam, was performed. The treatments were analysed and the disease-free and total survival rate were calculated. HCC was diagnosed in 461 patients during the study period. Cirrhosis was present in 295 patients (64%). Treatment with curative intent was pursued in 184 patients through partial liver resection, orthotopic liver transplantation or radiofrequency ablation. The group of patients without cirrhosis contained significantly more women (38% versus 18%) (p < 0.001), showed less hepatitis B or C infection (34% versus 74%) (p < 0.001) and had a larger median tumour size (80 mm (range: 3-227) versus 35 mm (range: 8-200)) (p < 0.001). Patients without cirrhosis were mainly treated by partial liver resection (37% versus 10%) (p < 0.001) and less by liver transplantation (1% versus 13%) (p < 0.001) or radiofrequency ablation (5% versus 16%) (p = 0.001). Median follow-up was 31 months (range: 1-108). Without stratification according to treatment, the overall 3-year survival in patients with non-cirrhotic and cirrhotic HCC was 30% and 32%, respectively (difference not significant). Patients who had undergone potential curative treatment in cirrhotic or non-cirrhotic livers had a 3-year survival rate of 54% and 59%, respectively (difference not significant). The recurrence rate of HCC without cirrhosis was 39%, of which 31% in the first year. The recurrence rate with cirrhosis was 37%, of which 23% in the first year (difference not significant). The presence of liver cirrhosis was strongly associated with treatment options for patients with HCC but not with the prognosis for a recurrence of HCC or the survival rate following potential curative treatment.