caa a22 4500 445333162 CHVBK 20180317142744.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1245/s10434-010-1463-8 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1463-8 Improved Diagnostic Imaging and Interventional Therapies Prolong Survival After Resection for Hepatocellular Carcinoma in Cirrhosis: The University of Bologna Experience Over 10Years [Elektronische Daten] [Alessandro Cucchetti, Matteo Zanello, Matteo Cescon, Giorgio Ercolani, Massimo Del Gaudio, Matteo Ravaioli, Gian Grazi, Antonio Pinna] Background: With substantial improvements in perioperative care and surgical technique, both mortality and morbidity after liver resection have progressively decreased; however, long-term prognosis is greatly affected by tumor recurrence, which represents the most frequent cause of death. The aim of this study is to analyze the outcome after hepatic resection in the present clinical scenario, where great improvements in diagnostic techniques, surveillance schedules, in other active treatments will potentially have a positive impact on survival. Methods: Data from 300 consecutive hepatic resections performed on cirrhotic patients in a tertiary-care referral hospital from 1997 and 2008 were reviewed, and survival was calculated for the two periods considered. The first group of patients underwent hepatectomy between 1997 and 2002 (n=126) and the second group of patients between 2003 and 2008 (n=174). Results: In the more recent period, tumor selection criteria for resectability included more patients with multinodular tumors so that solitary tumors decreased from 89.7 to 78.7% (P=0.019); however, the tumor, node, metastasis (TNM) system stage remained unaffected. The 5-year recurrence rate remained similar (67.4 vs. 65.8%; P=0.836). Despite these features, the 5-year patient survival increased from 52.6 to 65.8% (P=0.023). This end result was related to a larger proportion of patients with tumor recurrence undergoing repeat resection or salvage transplantation that increased from 22.2 to 36.9% (P=0.039). Conclusions: The increased survival is most likely the result of more stringent follow-up as well as increased accuracy in detecting recurrence at earlier stages, and consequently of more chances for potential cure when treating recurrent tumor. Society of Surgical Oncology, 2010 Cucchetti Alessandro Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Zanello Matteo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Cescon Matteo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Ercolani Giorgio Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Del Gaudio Massimo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Ravaioli Matteo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Grazi Gian Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Pinna Antonio Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1630-1637 1068-9265 18:6<1630 2011 18 10434 https://doi.org/10.1245/s10434-010-1463-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1463-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cucchetti Alessandro Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 700 1- Zanello Matteo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 700 1- Cescon Matteo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 700 1- Ercolani Giorgio Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 700 1- Del Gaudio Massimo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 700 1- Ravaioli Matteo Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 700 1- Grazi Gian Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 700 1- Pinna Antonio Liver and Multiorgan Transplant Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1630-1637 1068-9265 18:6<1630 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer