Surgical outcome of hepatocellular carcinoma patients with biliary tumor thrombi
Wenyu Shao1, Chengjun Sui, Zhenyu Liu
1Department of Hepato-Biliary-Pancreato-Vascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, PR China.
Insights
Hepatocellular carcinoma (HCC) patients with biliary tumor thrombi (BTT) experience significantly worse surgical outcomes and higher recurrence rates. Despite poor prognosis, resection is recommended due to limited alternative treatments.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Biliary tumor thrombi (BTT) represent a rare but critical complication in HCC.
- Understanding the impact of BTT on surgical outcomes is crucial for patient management.
Purpose of the Study:
- To evaluate the surgical outcomes of HCC patients presenting with BTT.
- To compare the prognosis of HCC patients with and without BTT after resection.
Main Methods:
- A comparative study design was employed.
- Surgical outcomes of 27 HCC patients with BTT (Group I) were analyzed.
- Outcomes were compared against a control group of 270 HCC patients without BTT (Group II).
Main Results:
- HCC patients with BTT showed significantly lower 1-, 3-, and 5-year survival rates (70.3%, 25.9%, 7.4%) compared to those without BTT (90.6%, 54.0%, 37.7%).
- Early recurrence rates (≤ 1 year) were substantially higher in the BTT group (70.3%) versus the non-BTT group (34.8%).
- One patient in the BTT group experienced fatal hepatic failure within 30 days post-resection.
Conclusions:
- Hepatocellular carcinoma with biliary tumor thrombi is associated with a poorer prognosis following surgical resection.
- Surgical resection should be considered for HCC with BTT, especially given the absence of effective alternative therapies.
- BTT presence is a significant negative prognostic factor in HCC surgical management.
Background:
To investigate the surgical outcome of hepatocellular carcinoma (HCC) patients with biliary tumor thrombi (BTT).
Methods:
Surgical outcome of 27 HCC patients with BTT (group I) were compared with randomly selected HCC patients without BTT (group II; n = 270).
Results:
One patient in group I died of hepatic failure within 30 days after resection. The 1-, 3- and 5-year cumulative survival rates of group I were 70.3%, 25.9%, and 7.4%, respectively; these were significantly lower than those of group II (90.6%, 54.0%, and 37.7%) (P <0.001). The rates of early recurrence (≤ 1 year) after resection were significantly higher in group I than group II (70.3% vs. 34.8%) (P < 0.001).
Conclusion:
HCC patients with BTT had a worse prognosis after resection than those without BTT. Resection should be considered for these tumors given the lack of effective alternative therapies.