RESUMEN
OBJECTIVE: To explore prognostic factors by comparing the efficacy of salvage liver transplantation (sLT) and rehepatectomy (RH) for the treatment of recurrent hepatocellular carcinoma after hepatectomy. METHODS: Clinical data were collected for 124 patients treated at our center from January 2012 to August 2018. The median follow-up time for the patients was 39 months. By analyzing the clinical data between the sLT group (46 cases) and RH group (78 cases), the factors affecting the prognosis of patients were compared. RESULTS: The proportion of alpha-fetoprotein (AFP) ≥ 100 µg/L in the recurrence group was significantly higher than that in the recurrence-free group (70.0% vs 22.2%, P = .014). The postoperative overall survival (OS) and recurrence-free survival (RFS) were better in the sLT group than in the RH group (81.2% vs 36.9%, P < .01; 77.1% vs 55.6%, P = .019). In the sLT group, the OS and RFS in the AFP < 100 µg/L group were superior to those in the AFP ≥ 100 µg/L group (P = .046 and P = .002). CONCLUSION: The sLT group had achieved better efficacy than RH group, but when AFP ≥ 100 µg/L, sLT did not achieve better efficacy than RH.
Asunto(s)
Carcinoma Hepatocelular , Hepatectomía , Neoplasias Hepáticas , Trasplante de Hígado , Carcinoma Hepatocelular/cirugía , Humanos , Neoplasias Hepáticas/cirugía , Recurrencia Local de Neoplasia/cirugía , Estudios Retrospectivos , Terapia RecuperativaAsunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Hepatectomía , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Anciano , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Quimioterapia Adyuvante , Supervivencia sin Enfermedad , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patología , Masculino , Inestabilidad de Microsatélites , Receptor de Muerte Celular Programada 1/antagonistas & inhibidoresRESUMEN
Background: To retrospectively analyze the short-term outcomes between open hepatectomy (OH) and laparoscopic hepatectomy (LH) in the treatment of recurrent hepatocellular carcinoma (HCC). The objective is to develop the optimal surgical method for patients with recurrent liver cancer after operation. Methods: We retrospectively reviewed the data of 165 HCC patients whose cancer recurred after hepatectomy between January 2015 and March 2021 at our medical center. According to the inclusion and exclusion criteria, a total of 74 patients were eventually enrolled in this study. Results: Tumors located in S1, S7, or S8 and larger tumor diameters were more frequent in the OH group, and the difference was statistically significant. Furthermore, there were notable differences between the LH and OH groups in terms of intraoperative blood loss (140.00 vs. 348.68 mL, P<0.001), mean operation time (150.95 vs. 203.28 min, P=0.024), and mean postoperative hospital stay (6.76 vs. 11.28 days, P=0.014). There were no statistically significant differences in the remaining characteristics between the two groups. There was no significant difference in recurrence-free survival and overall survival between the two groups. Conclusions: Compared with OH, LH can significantly reduce the amount of intraoperative blood loss and shorten the operation time and postoperative hospital stay. At the same time, laparoscopic surgery may be a better surgical approach for patients with tumors of smaller diameter located in segments 2 to 6.