Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
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
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.