Preoperative Liver Function Guiding HCC Resection in Normal and Cirrhotic Liver.
13C breath test
Cirrhosis
Hepatocellular carcinoma
Liver function
Liver surgery
Postoperative liver failure
Journal
Visceral medicine
ISSN: 2297-4725
Titre abrégé: Visc Med
Pays: Switzerland
ID NLM: 101681546
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
11
09
2019
accepted:
23
04
2020
entrez:
12
5
2021
pubmed:
13
5
2021
medline:
13
5
2021
Statut:
ppublish
Résumé
Liver resection is the most effective available therapy for patients with hepatocellular carcinoma (HCC). The accurate selection of patients for surgery requires determination of technical resectability and the risk of recurrence, as well as assessment of liver function and functional reserve to avoid postoperative liver failure. Previous studies have underlined the effectiveness and reliability of the LiMAx® test to evaluate liver function preoperatively. Nevertheless, data concerning HCC evaluation are lacking. From 2014 to 2019, 92 patients with HCC underwent additional assessment of liver function using the LiMAx test prior to decision for or against liver resection. Preoperative LiMAx results were compared between cirrhotic and noncirrhotic liver. The clinical decision for surgery was evaluated applying the various liver function parameters available. Forty-six patients underwent liver resection. The LiMAx results were higher in resected patients (388 vs. 322 µg/kg/h; Preoperative determination of liver function by the LiMAx test enables effective and safe patient selection for HCC resection in both cirrhotic and noncirrhotic liver.
Sections du résumé
BACKGROUND
BACKGROUND
Liver resection is the most effective available therapy for patients with hepatocellular carcinoma (HCC). The accurate selection of patients for surgery requires determination of technical resectability and the risk of recurrence, as well as assessment of liver function and functional reserve to avoid postoperative liver failure. Previous studies have underlined the effectiveness and reliability of the LiMAx® test to evaluate liver function preoperatively. Nevertheless, data concerning HCC evaluation are lacking.
METHODS
METHODS
From 2014 to 2019, 92 patients with HCC underwent additional assessment of liver function using the LiMAx test prior to decision for or against liver resection. Preoperative LiMAx results were compared between cirrhotic and noncirrhotic liver. The clinical decision for surgery was evaluated applying the various liver function parameters available.
RESULTS
RESULTS
Forty-six patients underwent liver resection. The LiMAx results were higher in resected patients (388 vs. 322 µg/kg/h;
CONCLUSION
CONCLUSIONS
Preoperative determination of liver function by the LiMAx test enables effective and safe patient selection for HCC resection in both cirrhotic and noncirrhotic liver.
Identifiants
pubmed: 33977098
doi: 10.1159/000508172
pii: vis-0037-0094
pmc: PMC8077495
doi:
Types de publication
Journal Article
Langues
eng
Pagination
94-101Informations de copyright
Copyright © 2020 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Dig Dis Sci. 2014 Dec;59(12):2983-91
pubmed: 24993690
Hepatology. 2015 Aug;62(2):440-51
pubmed: 25678263
J Surg Res. 2004 Feb;116(2):248-52
pubmed: 15013363
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
JAMA Surg. 2017 Mar 15;152(3):e165059
pubmed: 28052155
J Surg Res. 2015 Jan;193(1):184-9
pubmed: 25150081
J Hepatol. 2015 Mar;62(3):617-24
pubmed: 25450706
HPB (Oxford). 2010 Mar;12(2):139-46
pubmed: 20495659
Ann Surg. 2009 Jul;250(1):119-25
pubmed: 19561474
HPB (Oxford). 2019 Jul;21(7):912-922
pubmed: 30733048
Br J Surg. 1997 Sep;84(9):1255-9
pubmed: 9313707
Ann Surg Oncol. 2016 Mar;23(3):994-1002
pubmed: 26487000
Ann Surg. 2006 Mar;243(3):373-9
pubmed: 16495703
Br J Surg. 2016 Mar;103(4):348-56
pubmed: 26780107
Liver Int. 2008 Jul;28(6):767-80
pubmed: 18647141
World J Gastroenterol. 2015 Nov 7;21(41):11567-83
pubmed: 26556987
Int J Surg. 2019 Nov;71:56-65
pubmed: 31494333
Liver Int. 2007 Sep;27(7):969-76
pubmed: 17696936
Dtsch Arztebl Int. 2017 Aug 7;114(31-32):519-526
pubmed: 28835324
Surg Clin North Am. 2004 Apr;84(2):355-73
pubmed: 15062650
Gastroenterol Clin North Am. 2018 Sep;47(3):569-584
pubmed: 30115438
Liver Transpl. 2017 Jun;23(6):836-844
pubmed: 28295992
World J Surg. 2011 Sep;35(9):2073-82
pubmed: 21656309
Surgery. 2011 May;149(5):713-24
pubmed: 21236455
BJS Open. 2018 Jun 14;2(5):301-309
pubmed: 30263981
Surgery. 2016 Feb;159(2):399-408
pubmed: 26209567
Hepatogastroenterology. 2014 Sep;61(134):1722-9
pubmed: 25436369