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Liver Resection for De Novo Hepatocellular Carcinoma Complicated by Pyogenic Liver Abscess: A Clinical Challenge.
- Source :
-
World journal of surgery [World J Surg] 2016 Feb; Vol. 40 (2), pp. 412-8. - Publication Year :
- 2016
-
Abstract
- Background: De novo hepatocellular carcinoma (HCC) complicated by pyogenic liver abscess is rare, and the standard of care for this disease has yet been defined. This study assesses whether liver resection can be recommended as its standard treatment.<br />Methods: This retrospective study reviewed the prospectively collected data of the 1725 patients who underwent primary liver resection for HCC at our hospital during the period from December 1989 to December 2012. Outcomes were compared between patients with and without liver abscess.<br />Results: Twenty-two (1.28 %) patients had HCC and liver abscess. Fourteen of them received preoperative drainage. Patients with and without abscess had similar tumor characteristics, but patients with abscess had more operative blood loss (2.2 vs. 0.8 L; p < 0.0001) and more of them needed blood transfusion (63.6 vs. 23.1 %; p < 0.0001). They also had a longer hospital stay (38.5 vs. 10 days; p < 0.0001), a higher hospital mortality (40.9 vs. 2.8 %; p < 0.001), a higher postoperative complication rate (100 vs. 25.9 %; p < 0.0001), and poorer 1, 3, and 5-years disease-free survival rates (p = 0.023).<br />Conclusions: The post-resection mortality of the patients with de novo HCC complicated by pyogenic liver abscess was so high that liver resection is not recommended as the standard treatment. More research is needed to determine the best therapy for this rare disease.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Blood Loss, Surgical
Blood Transfusion
Carcinoma, Hepatocellular mortality
Disease-Free Survival
Drainage
Female
Hepatectomy adverse effects
Hepatectomy mortality
Hospital Mortality
Humans
Length of Stay
Liver Abscess, Pyogenic mortality
Liver Neoplasms mortality
Male
Middle Aged
Preoperative Care
Retrospective Studies
Young Adult
Carcinoma, Hepatocellular complications
Carcinoma, Hepatocellular surgery
Liver Abscess, Pyogenic complications
Liver Abscess, Pyogenic surgery
Liver Neoplasms complications
Liver Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2323
- Volume :
- 40
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- World journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 26316116
- Full Text :
- https://doi.org/10.1007/s00268-015-3239-6