Back to Journals » OncoTargets and Therapy » Volume 7

Prognosis of patients with hepatocellular carcinoma and hypersplenism after surgery: a single-center experience from the People's Republic of China

Authors Li C, Zhao H, Zhao J, Li Z, Huang Z, Zhang Y, Bi X, Cai J

Received 26 March 2014

Accepted for publication 17 April 2014

Published 9 June 2014 Volume 2014:7 Pages 957—964

DOI https://doi.org/10.2147/OTT.S64921

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


Cong Li, Hong Zhao, Jianjun Zhao, Zhiyu Li, Zhen Huang, Yefan Zhang, Xinyu Bi, Jianqiang Cai

Department of Abdominal Surgery, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China

Purpose: As prognosis of patients with hepatocellular carcinoma (HCC) and hypersplenism is rarely reported, this study examined prognostic factors for patients who underwent surgery for this condition.
Patients and methods: This study retrospectively analyzed prognostic factors in 181 consecutive HCC patients using univariate and multivariate analyses, as well as subgroup analyses for disease-free survival (DFS) and overall survival (OS) of two groups: one group who received splenectomies (Sp) and one group who did not (non-Sp).
Results: 1, 3, and 5 year OS rates were 88.4%, 67.1%, and 52.8%, respectively; corresponding DFS rates were 67.0%, 43.8%, and 31.6%, respectively. Age ≥55 years old, cigarette smoking, tumor size ≥5 cm, microvascular invasion, and Child-Pugh grade B (versus A) correlated significantly with OS (P<0.05). Interestingly, in patients with tumor lymph node metastasis (TNM) stage I disease, DFS of the Sp-group (median DFS, 24.1 months; n=34) was significantly lower than that of the non-Sp group (median DFS, 62.1 months; n=74), P=0.034; whereas at TNM stage II, OS of the Sp-group (median OS, 79.1 months; n=21) was significantly better than that of the non-Sp group (median OS, 23.3 months; n=30), P=0.018.
Conclusion: Hepatectomy without concomitant splenectomy can contribute to improved DFS of TNM stage I HCC patients with hypersplenism, whereas simultaneous hepatectomy and splenectomy can prolong OS for patients at TNM stage II.

Keywords: hepatectomy, splenectomy, overall survival, disease-free survival

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]