HPB
DOI:10.1111/hpb.12416
ORIGINAL ARTICLE
Hepatectomy for hepatocellular carcinoma larger than 10 cm: preoperative risk stratification to prevent futile surgery ne Sebagh4, Chady Salloum1, Julien Calderaro1,3, Alain Luciani1,3, Chetana Lim1,2,*, Philippe Compagnon1,3,*, Myle 1 1,3 rard Pascal , Alexis Laurent , Eric Levesque1,3, Umberto Maggi1,5, Cyrille Feray1,3, Daniel Cherqui4, Denis Castaing4 Ge & Daniel Azoulay1,3 pato-Bilio-Pancre atique et Transplantation He patique (Department of Hepatopancreatobiliary Surgery and Liver Transplantation), Service de Chirurgie He ^ pitaux de Paris (AP-HP) Ho ^ pital Henri Mondor, Cre teil, 2Unite 965, Institut National de la Sante et de la Recherche Me dicale Assistance Publique–Ho 955, Inserm, Cre teil, 4Centre He pato-Biliaire (Hepatobiliary Centre), AP-HP (Inserm) (National Institute for Health and Medical Research), Paris, 3Unite 5 ^ pital Paul Brousse, Villejuif, France, and Hepatobiliary Surgery and Liver Transplant Unit, Ospedale Maggiore Policlinico Milano, Milano, Italy Ho 1
Abstract Objectives: Appropriate patient selection is important to achieving good outcomes and obviating futile surgery in patients with huge (≥10 cm) hepatocellular carcinoma (HCC). The aim of this study was to identify independent predictors of futile outcomes, defined as death within 3 months of surgery or within 1 year from early recurrence following hepatectomy for huge HCC. Methods: The outcomes of 149 patients with huge HCCs who underwent resection during 1995–2012 were analysed. Multivariate logistic regression analysis was performed to identify preoperative independent predictors of futility. Results: Independent predictors of 3-month mortality (18.1%) were: total bilirubin level >34 lmol/l [P = 0.0443; odds ratio (OR) 16.470]; platelet count of
DOI:10.1111/hpb.12416
ORIGINAL ARTICLE
Hepatectomy for hepatocellular carcinoma larger than 10 cm: preoperative risk stratification to prevent futile surgery ne Sebagh4, Chady Salloum1, Julien Calderaro1,3, Alain Luciani1,3, Chetana Lim1,2,*, Philippe Compagnon1,3,*, Myle 1 1,3 rard Pascal , Alexis Laurent , Eric Levesque1,3, Umberto Maggi1,5, Cyrille Feray1,3, Daniel Cherqui4, Denis Castaing4 Ge & Daniel Azoulay1,3 pato-Bilio-Pancre atique et Transplantation He patique (Department of Hepatopancreatobiliary Surgery and Liver Transplantation), Service de Chirurgie He ^ pitaux de Paris (AP-HP) Ho ^ pital Henri Mondor, Cre teil, 2Unite 965, Institut National de la Sante et de la Recherche Me dicale Assistance Publique–Ho 955, Inserm, Cre teil, 4Centre He pato-Biliaire (Hepatobiliary Centre), AP-HP (Inserm) (National Institute for Health and Medical Research), Paris, 3Unite 5 ^ pital Paul Brousse, Villejuif, France, and Hepatobiliary Surgery and Liver Transplant Unit, Ospedale Maggiore Policlinico Milano, Milano, Italy Ho 1
Abstract Objectives: Appropriate patient selection is important to achieving good outcomes and obviating futile surgery in patients with huge (≥10 cm) hepatocellular carcinoma (HCC). The aim of this study was to identify independent predictors of futile outcomes, defined as death within 3 months of surgery or within 1 year from early recurrence following hepatectomy for huge HCC. Methods: The outcomes of 149 patients with huge HCCs who underwent resection during 1995–2012 were analysed. Multivariate logistic regression analysis was performed to identify preoperative independent predictors of futility. Results: Independent predictors of 3-month mortality (18.1%) were: total bilirubin level >34 lmol/l [P = 0.0443; odds ratio (OR) 16.470]; platelet count of
