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Treatment of fibrolamellar hepatoma with subtotal hepatectomy or transplantation

Pinna, AD and Iwatsuki, S and Lee, RG and Todo, S and Madariaga, JR and Marsh, JW and Casavilla, A and Dvorchik, I and Fung, JJ and Starzl, TE (1997) Treatment of fibrolamellar hepatoma with subtotal hepatectomy or transplantation. Hepatology, 26 (4). 877 - 883. ISSN 0270-9139

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Fibrolamellar hepatoma (FL-HCC) is an uncommon variant of hepatocellular carcinoma (HCC), distinguished by histopathological features suggesting greater differentiation than conventional HCC. However, the optimal treatment and the prognosis of FL-HCC have been controversial. Follow-up studies are available from 1 year to 27 years, after 41 patients with FL-HCC were treated with partial hepatectomy (PHx) (28 patients) or liver transplantation (13 patients). In this retrospective study, the effect on outcome was determined for the pTNM stage and other prognostic factors routinely recorded at the time of surgery. Cumulative survival at 1, 3, 5, and 10 years was 97.6%, 72.3%, 66.2%, and 47.4%. Tumor-free survival at these times was 80.3%, 49.4%, 33%, and 29.3%. The TNM stage was significantly associated with tumor-free survival. Patients with positive nodes had a shorter tumor-free survival than those with negative nodes (P < .015). Patient survival was most adversely affected by the presence of vascular invasion (P < .05). FL-HCC is an indolently growing tumor of the liver, which usually was diagnosed in our patients at a stage too advanced for effective surgical treatment of most conventional HCC. Nevertheless, long-term survival frequently was achieved with aggressive surgical treatment. When a subtotal hepatectomy could not be performed, total hepatectomy (THx) with liver transplantation was a valuable option.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Pinna, AD
Iwatsuki, S
Lee, RG
Todo, S
Madariaga, JR
Marsh, JW
Casavilla, A
Dvorchik, I
Fung, JJ
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1997
Date Type: Publication
Journal or Publication Title: Hepatology
Volume: 26
Number: 4
Page Range: 877 - 883
DOI or Unique Handle: 10.1002/hep.510260412
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0270-9139
Other ID: uls-drl:31735062127109, Starzl CV No. 1988
Date Deposited: 08 Apr 2010 17:33
Last Modified: 05 Feb 2019 11:55


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