RESUMEN
INTRODUCTION AND AIMS: Hepatocellular carcinoma (HCC) is a primary malignant tumor of liver epithelial cells and is the most frequent primary liver cancer. The broadening of transplantation and resectability criteria has made therapeutic decisions more complex. Our aim was to describe the clinical and survival characteristics of patients with HCC treated through resection or liver transplantation at our hospital and identify the presence of factors that enable outcome prediction and facilitate therapeutic decision-making. MATERIALS AND METHODS: Patients with HCC that underwent surgery with curative intent at the Hospital Universitario Marqués de Valdecilla, within the time frame of 2007 and 2017, were retrospectively identified. Survival, mortality, disease-free interval, and different outcome-related variables were analyzed. RESULTS: Ninety-six patients with a mean follow-up after surgery of 44 months were included. Overall mortality and recurrence were higher in the resection group. Mean survival was 51.4 months in the liver transplantation group and 37.5 months in the resection group, and the disease-free interval was 49.4⯱â¯37.2 and 27.4⯱â¯28.7 months, respectively (pâ¯=â¯0.002). The tumor burden score was statistically significant regarding risk for recurrence and specific mortality. CONCLUSIONS: There appears to be no patient subgroup in whom the results of surgical resection were superior or comparable to those of transplantation. Tumor burden determination could be a useful tool for patient subclassification and help guide therapeutic decision-making.
Asunto(s)
Carcinoma Hepatocelular , Hepatectomía , Neoplasias Hepáticas , Trasplante de Hígado , Centros de Atención Terciaria , Humanos , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/mortalidad , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/mortalidad , Masculino , Persona de Mediana Edad , Femenino , Estudios Retrospectivos , Trasplante de Hígado/mortalidad , Anciano , Análisis de Supervivencia , Adulto , Recurrencia Local de Neoplasia/cirugía , Resultado del Tratamiento , Estudios de Seguimiento , Carga Tumoral , Supervivencia sin EnfermedadRESUMEN
Introduction: Although cholecystectomy is the treatment of choice for acute cholecystitis (AC), in patients with high surgical risk percutaneous cholecystostomy (PC) is chosen in some cases. The aim of this report is to follow up these patients and evaluate biliary recurrences after PC. Methods: A descriptive retrospective study was carried out in a third level hospital from August 2005 to December 2014. All patients diagnosed with acute lithiasis cholecystitis who were indicated as initial treatment with antibiotic therapy and PC echo-guided were included. Patients requiring emergent cholecystectomy during hospital and those who died during the AC episode were excluded. After hospital discharge, the patients were divided into two groups: group 1 (interval cholecystectomy) and group 2 (no surgery). Results: From the 86 healed patients, there were 8 losses in the follow-up, so 78 patients were analyzed: group 1 (n = 12) and group 2 (n = 66)
No disponible