PMID- 23334253
OWN - NLM
STAT- MEDLINE
DCOM- 20131223
LR  - 20130517
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 20
IP  - 6
DP  - 2013 Jun
TI  - Surgical resection in hepatocellular carcinoma patients with minimal background 
      fibrosis: a strategy in the era of organ shortage.
PG  - 2043-8
LID - 10.1245/s10434-012-2857-6 [doi]
AB  - BACKGROUND: Surgical therapies for hepatocellular carcinoma (HCC) represent the 
      potentially curative approaches and provide patients the greatest survival 
      advantage. We sought to examine the outcomes of patients with HCC treated with 
      surgical resection, transplantation, and local ablation. METHODS: The 
      Surveillance, Epidemiology, and End Results database was queried for all patients 
      with nonmetastatic HCC from 2004 to 2007 who underwent local ablation (LA), 
      segmental resection (SR), hemihepatectomy or extended resection (ER), or 
      transplantation (TP). RESULTS: Of 16,209 patients with HCC, 3,989 (24.6 %) met 
      criteria for inclusion and received therapies: 1,550 LA (39 %), 703 SR (18 %), 
      619 ER (16 %), and 1,117 TP (28 %). AFP was elevated in 69 % (2,026 of 2,921), 
      and fibrosis grade 0-4 was noted in 32 % (368 of 1,156). The 3-year survival by 
      procedure was 34 % (LA), 50 % (SR), 54 % (ER), and 74 % (TP), p = .001. In 
      patients with minimal fibrosis, 1-year survival for patients undergoing resection 
      was similar to TP (85 vs. 92 %, p = .346), but greater than LA (69 %, p = .001). 
      DISCUSSION: Survival after surgical resection for HCC patients without extensive 
      fibrosis appears to be superior to ablation and non-inferior to transplantation. 
      In an era of organ shortage, transplantation may be better reserved for patients 
      with cirrhosis and/or unresectable disease.
FAU - Groeschl, Ryan T
AU  - Groeschl RT
AD  - Division of Surgical Oncology, Department of Surgery, Medical College of 
      Wisconsin, Milwaukee, WI, USA. rgroesch@mcw.edu
FAU - Clark Gamblin, T
AU  - Clark Gamblin T
FAU - Turaga, Kiran K
AU  - Turaga KK
LA  - eng
PT  - Journal Article
DEP - 20130120
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
RN  - 0 (alpha-Fetoproteins)
SB  - IM
MH  - Ablation Techniques/*statistics & numerical data
MH  - Aged
MH  - Carcinoma, Hepatocellular/blood/complications/*surgery
MH  - Female
MH  - Hepatectomy/*statistics & numerical data
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Liver Cirrhosis/complications/*pathology
MH  - Liver Neoplasms/blood/complications/*surgery
MH  - Liver Transplantation/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - SEER Program
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - alpha-Fetoproteins/metabolism
EDAT- 2013/01/22 06:00
MHDA- 2013/12/24 06:00
CRDT- 2013/01/22 06:00
PHST- 2012/07/17 00:00 [received]
PHST- 2013/01/22 06:00 [entrez]
PHST- 2013/01/22 06:00 [pubmed]
PHST- 2013/12/24 06:00 [medline]
AID - 10.1245/s10434-012-2857-6 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2013 Jun;20(6):2043-8. doi: 10.1245/s10434-012-2857-6. Epub 2013 
      Jan 20.