Elshaarawy O, Aman A, Zakaria HM, Zakareya T, Gomaa A, Elshimi E, Abdelsameea E. Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis. World J Gastrointest Oncol 2021; 13(5): 424-439 [PMID: 34040703 DOI: 10.4251/wjgo.v13.i5.424]
Corresponding Author of This Article
Esam Elshimi, MBChB, MD, MSc, Doctor, Full Professor, Department of Hepatology, Gastroenterology and Liver Transplantation, National Liver Institute, Menoufia University, Yassin Abdelghaffar Street, Shebine Elkom 32511, Menoufia, Egypt. eelshimi@liver-eg.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. May 15, 2021; 13(5): 424-439 Published online May 15, 2021. doi: 10.4251/wjgo.v13.i5.424
Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis
Omar Elshaarawy, Aya Aman, Hazem Mohamed Zakaria, Talaat Zakareya, Asmaa Gomaa, Esam Elshimi, Eman Abdelsameea
Omar Elshaarawy, Aya Aman, Talaat Zakareya, Asmaa Gomaa, Esam Elshimi, Eman Abdelsameea, Department of Hepatology, Gastroenterology and Liver Transplantation, National Liver Institute, Menoufia University, Shebine Elkom 32511, Menoufia, Egypt
Hazem Mohamed Zakaria, Department of Hepatobiliary Pancreatic Surgery, National Liver Institute, Menoufia University, Shebine Elkom 32511, Menoufia, Egypt
Author contributions: Abdelsameea E and Elshimi E performed the study concept and design; all authors performed the data collection, revision and preparing the manuscript, and wrote the final manuscript.
Institutional review board statement: The study protocol was approved by the ethics committee (for medical research) in accordance with the Declaration of Helsinki and by the Institutional Review Board of the National Liver Institute, Menoufia University-Egypt, February 2017, No. IRB00003413.
Informed consent statement: Written informed consent was obtained from each patient included in the study.
Conflict-of-interest statement: All authors have no conflict of interests.
Data sharing statement: We have no additional data to be shared.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Esam Elshimi, MBChB, MD, MSc, Doctor, Full Professor, Department of Hepatology, Gastroenterology and Liver Transplantation, National Liver Institute, Menoufia University, Yassin Abdelghaffar Street, Shebine Elkom 32511, Menoufia, Egypt. eelshimi@liver-eg.org
Received: January 6, 2021 Peer-review started: January 6, 2021 First decision: January 25, 2021 Revised: February 11, 2021 Accepted: April 22, 2021 Article in press: April 22, 2021 Published online: May 15, 2021 Processing time: 120 Days and 16 Hours
ARTICLE HIGHLIGHTS
Research background
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world; and it is one of the three frequently diagnosed cancers in Egypt. Unfortunately, most patients with HCC in Egypt are initially diagnosed with intermediate or advanced stages. Therefore, the curative treatments including liver resection are limited only to a small percent of patients. The success of resection depends on the ability to achieve a resection with tumor free margins while leaving behind an adequate liver volume.
Research motivation
It is difficult to identify the most accurate prognostic factors associated with improved survival and the predictors of decompensation after curative resection.
Research objectives
To determine prognostic factors for survival and outcome after liver resection as well as validating post hepatectomy liver failure score (PHLF) and compare it to the performance of other established scoring systems which could help the prognosis of those patients after surgery.
Research methods
We accrued data of 120 patients who had liver resection from 2010 to 2017 and included those with full follow up data. We performed analysis for the data to determine the prognostic factors and test the validity of the proposed score as well as compare it's validity to other established scoring systems.
Research results
Preoperative model of end stage liver disease (MELD) score and tumor diameter can precisely predict the risk of hepatic decompensation after surgery while preoperative MELD score together with different grades of PHLF and the incidence of HCC recurrence can predict survival of patients post operation.
Research conclusions
The proposed (PHLF) scoring system as well as the established MELD score are good prognostic tools for survival while MELD score with tumor diameter are predictive for the risk of hepatic decompensation.
Research perspectives
These models should be prospectively validated in determining decisions regarding hepatic resection in such group of patients.
