Synchronous splenectomy and hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A case-control study.

Abstract

AIM:

To investigate whether the use of synchronous hepatectomy and splenectomy (HS) is more effective than hepatectomy alone (HA) for patients with hepatocellular carcinoma (HCC) and hypersplenism.

METHODS:

From January 2007 to March 2013, 84 consecutive patients with HCC and hypersplenism who underwent synchronous hepatectomy and splenectomy in our center were compared with 84 well-matched patients from a pool of 268 patients who underwent hepatectomy alone. The short-term and long-term outcomes of the two groups were analyzed and compared.

RESULTS:

The mean time to recurrence was 21.11±12.04 mo in the HS group and 11.23±8.73 mo in the HA group, and these values were significantly different (P=0.001). The 1-, 3-, 5-, and 7-year disease-free survival rates for the patients in the HS group and the HA group were 86.7%, 70.9%, 52.7%, and 45.9% and 88.1%, 59.4%, 43.3%, and 39.5%, respectively (P=0.008). Platelet and white blood cell counts in the HS group were significantly increased compared with the HA group one day, one week, one month and one year postoperatively (P<0.001). Splenectomy and micro-vascular invasion were significant independent prognostic factors for disease-free survival. Gender, tumor number, and recurrence were independent prognostic factors for overall survival.

CONCLUSION:

Synchronous hepatectomy and hepatectomy potentially improves disease-free survival rates and alleviates hypersplenism without increasing the surgical risks for patients with HCC and hypersplenism.

• Authors: Xiao-Yun Zhang, Chuan Li, Tian-Fu Wen, Lu-Nan Yan, Bo Li, Jia-Yin Yang, Wen-Tao Wang, Li Jiang
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 21 Issue 8 Pg. 2358-66 (Feb 28 2015) ISSN: 2219-2840 [Electronic] United States
• PMID: 25741142 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Carcinoma, Hepatocellular (diagnosis, mortality, surgery)
• Case-Control Studies
• China
• Disease-Free Survival
• Female
• Hepatectomy (adverse effects, mortality)
• Humans
• Hypersplenism (diagnosis, mortality, surgery)
• Kaplan-Meier Estimate
• Liver Neoplasms (diagnosis, metabolism, surgery)
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Postoperative Complications (etiology)
• Proportional Hazards Models
• Risk Factors
• Splenectomy (adverse effects, mortality)
• Time Factors
• Treatment Outcome