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Portal hypertension may influence outcome but the preoperative definition and role of portal hypertension are far from clear. The aim of this study was to elucidate the influence of portal venous pressure (PVP) measured directly during surgery on outcomes of liver resection in patients with HCC. Methods: Patients who had resection of HCC between 1997 and 2009, and who underwent direct measurement of PVP immediately after laparotomy were enrolled. These patients were divided into groups with high (at least 20 cmH 2O) and low (less than 20 cmH 2O) PVP. The influence of PVP on overall and recurrence-free survival was analysed and prognostic factors were identified. Results: A total of 177 patients were enrolled, 129 in the low-PVP group and 48 in the high-PVP group. The 5-year overall survival rate (63·7 versus 31 per cent; P \u003c 0·001) and recurrence-free survival rate (52·5 versus 12 per cent; P \u003c 0·001) were significantly higher in patients with low PVP. In multivariable analysis, two or more tumours, tumour diameter at least 5 cm, high PVP, grade B liver damage and Hepatic Activity Index (HAI) grade 7 or more were significant predictors of poorer survival after liver resection. Two or more tumours, tumour diameter at least 5 cm and HAI grade 7 or more were significant predictors of poorer recurrence-free survival. 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Intraoperative portal venous pressure and long-term outcome after curative resection for hepatocellular carcinoma
http://hdl.handle.net/10069/33453
http://hdl.handle.net/10069/334536978592e-d8e9-4110-b81a-2594f042e685
名前 / ファイル | ライセンス | アクション |
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BJS99_1284.pdf (314.0 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2013-08-27 | |||||
タイトル | ||||||
タイトル | Intraoperative portal venous pressure and long-term outcome after curative resection for hepatocellular carcinoma | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | hepatocellular carcinoma | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | liver resection | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | portal venous pressure | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Hidaka, Masaaki
× Hidaka, Masaaki× Takatsuki, Mitsuhisa× Soyama, Akihiko× Tanaka, Takayuki× Muraoka, Izumi× Hara, Takanobu× Kuroki, Tamotsu× Kanematsu, Takashi× Eguchi, Susumu |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: Outcomes of liver resection for hepatocellular carcinoma (HCC) have improved owing to better surgical techniques and patient selection. Portal hypertension may influence outcome but the preoperative definition and role of portal hypertension are far from clear. The aim of this study was to elucidate the influence of portal venous pressure (PVP) measured directly during surgery on outcomes of liver resection in patients with HCC. Methods: Patients who had resection of HCC between 1997 and 2009, and who underwent direct measurement of PVP immediately after laparotomy were enrolled. These patients were divided into groups with high (at least 20 cmH 2O) and low (less than 20 cmH 2O) PVP. The influence of PVP on overall and recurrence-free survival was analysed and prognostic factors were identified. Results: A total of 177 patients were enrolled, 129 in the low-PVP group and 48 in the high-PVP group. The 5-year overall survival rate (63·7 versus 31 per cent; P < 0·001) and recurrence-free survival rate (52·5 versus 12 per cent; P < 0·001) were significantly higher in patients with low PVP. In multivariable analysis, two or more tumours, tumour diameter at least 5 cm, high PVP, grade B liver damage and Hepatic Activity Index (HAI) grade 7 or more were significant predictors of poorer survival after liver resection. Two or more tumours, tumour diameter at least 5 cm and HAI grade 7 or more were significant predictors of poorer recurrence-free survival. Conclusion: High PVP was associated with poor long-term outcome after liver resection for HCC. | |||||
書誌情報 |
British Journal of Surgery 巻 99, 号 9, p. 1284-1289, 発行日 2012-09 |
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出版者 | ||||||
出版者 | John Wiley and Sons Ltd | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 00071323 | |||||
DOI | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1002/bjs.8861 | |||||
権利 | ||||||
権利情報 | © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. | |||||
権利 | ||||||
権利情報 | This is the pre-peer reviewed version of the following article: British Journal of Surgery, 99(9), pp.1284-1289; 2012, which has been published in final form at http://dx.doi.org/10.1002/bjs.8861 | |||||
著者版フラグ | ||||||
出版タイプ | AM | |||||
出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | British Journal of Surgery, 99(9), pp.1284-1289; 2012 |