Portal Hypertension and Liver Resection in Patients With Hepatocellular Carcinoma

Conditions

Primary Liver Cancers

Keywords

portal hypertension, hepatocellular carcinoma, resection

Brief summary

According to the BCLC guidelines, surgical resection of hepatocellular carcinoma complicating cirrhosis is restricted to patients with preserved liver function, single nodule without vascular invasion and with hepatic venous gradient below 10 mmHg. However, other guideline treatment, especially from eastern countries demonstrated that surgical resection is safe and feasible and provides better survival than the treatment recommended by the BCLC system for patients with similar stage. The primary goal of this study is to assess the impact of HVPG on short and long-term outcomes in HCC patients who undergo liver resection.

Detailed description

Patients with HCC and candidates for hepatectomy are classified into two groups according to the presence of portal hypertension. Short- and long-term outcomes will be compared.

Lim C, Salloum C, Chalaye J, Lahat E, Costentin CE, Osseis M, Itti E, Feray C, Azoulay D.

2018-11-0342 citations

10.1016/j.hpb.2018.10.007

Safety of laparoscopic hepatectomy in patients with hepatocellular carcinoma and portal hypertension: interim analysis of an open prospective study.

Lim C, Osseis M, Lahat E, Doussot A, Sotirov D, Hemery F, Lantéri-Minet M, Feray C, Salloum C, Azoulay D.

2018-07-1225 citations

10.1007/s00464-018-6347-1

Short-term outcomes following hepatectomy for hepatocellular carcinoma within and beyond the BCLC guidelines: A prospective study.

Lim C, Salloum C, Osseis M, Lahat E, Gómez-Gavara C, Compagnon P, Luciani A, Feray C, Azoulay D.

2017-09-1911 citations

10.1016/j.hpb.2017.08.027

Interventions

PROCEDURELiver resection

Hepatectomy by either open, laparoscopic or robotic procedures

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Healthy volunteers

No

Inclusion criteria

Patients with hepatocellular carcinoma who undergo surgical resection (intention to treat analysis)

Design outcomes

Primary

Measure	Time frame	Description
Mortality	90 day	In-hospital or 90-day mortality

Secondary

Measure	Time frame	Description
morbidity	90 day	Overall and liver-related complications including liver failure, ascites, biliary fistula, bleeding, pulmonary complications, and renal complications. Grading system according to Clavien-Dindo classification
Survival outcomes	1,3 and 5 years	Including Overall survival and disease free survival

Other

Measure	Time frame	Description
Acute kidney injury	within 90 days after surgery	As defined by the KDIGIO criteria
Impact of PET CT on overall survival following liver resection	Before liver resection	quantitative assessment of metabolic uptake (FDG and choline)
Sarcopenia	Before liver resection	using computed tomography
Time from diagnosis to liver resection	from the date of diagnosis until the date of first referral and from the date of first referral to date of hepatectomy, assessed up to 3 months	—

Countries

France

Outcome results

None listed