Liver Resection for De Novo Hepatocellular Carcinoma Complicated by Pyogenic Liver Abscess: A Clinical Challenge.
World J Surg
; 40(2): 412-8, 2016 Feb.
Article
in En
| MEDLINE
| ID: mdl-26316116
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.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.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).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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Hepatocellular
/
Liver Abscess, Pyogenic
/
Liver Neoplasms
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
World J Surg
Year:
2016
Type:
Article
Affiliation country:
China