Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2017; 23(8): 1469-1476
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1469
Competing risk analysis on outcome after hepatic resection of hepatocellular carcinoma in cirrhotic patients
Alessandro Cucchetti, Carlo Sposito, Antonio Daniele Pinna, Davide Citterio, Matteo Cescon, Marco Bongini, Giorgio Ercolani, Christian Cotsoglou, Lorenzo Maroni, Vincenzo Mazzaferro
Alessandro Cucchetti, Antonio Daniele Pinna, Matteo Cescon, Giorgio Ercolani, Lorenzo Maroni, Department of Medical and Surgical Sciences, DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
Carlo Sposito, Davide Citterio, Marco Bongini, Christian Cotsoglou, Vincenzo Mazzaferro, Gastrointestinal Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), 20133 Milan, Italy
Author contributions: Cucchetti A and Sposito C had the original idea and designed the study; Cucchetti A, Pinna AD and Mazzaferro V wrote the manuscript; Cucchetti A performed statistical analysis; Sposito C, Cescon M and Ercolani G interpreted results and added important intellectual content in manuscript preparation; Citterio D, Bongini M, Cotsoglou C and Maroni L collected data and reviewed clinical charts.
Institutional review board statement: The study was reviewed and approved by the Local Ethics Committees.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent according to Italian law.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: 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/
Correspondence to: Alessandro Cucchetti, MD, Department of Medical and Surgical Sciences, DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. aleqko@libero.it
Telephone: +39-51-2144750 Fax: +39-51-2144184
Received: October 3, 2016
Peer-review started: October 7, 2016
First decision: November 21, 2016
Revised: December 2, 2016
Accepted: February 8, 2017
Article in press: February 8, 2017
Published online: February 28, 2017
Core Tip

Core tip: Optimal candidates for hepatectomy should benefit from the tumour removal that encompasses the risk of dying from post-operative liver function worsening and failure. This means that when evaluating patients for surgery, the competing risks of tumour-related death and of liver failure have to be weighed against each other, and considered from the point of view of available alternative therapies. In the present study, a large cohort of Child-Pugh class A cirrhotic patients submitted to curative (R0) hepatic resection for hepatocellular carcinoma was analysed to provide a competing-risk analysis of these two competing events.