Z Gastroenterol 2016; 54(12): 1343-1404
DOI: 10.1055/s-0036-1597463
4. Tumors/Liver Surgery
Georg Thieme Verlag KG Stuttgart · New York

Current therapeutical options for hepatocellular carcinoma in a german liver center – initial results of a retrospective data analysis

G Singh
1   UNiversity Clinic Würzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Str. 6, 970, Würzburg, Germany
,
I Klein
1   UNiversity Clinic Würzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Str. 6, 970, Würzburg, Germany
,
S Löb
1   UNiversity Clinic Würzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Str. 6, 970, Würzburg, Germany
,
O Götze
1   UNiversity Clinic Würzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Str. 6, 970, Würzburg, Germany
,
A Geier
1   UNiversity Clinic Würzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Str. 6, 970, Würzburg, Germany
,
JF Lock
1   UNiversity Clinic Würzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Str. 6, 970, Würzburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
19 December 2016 (online)

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Background: Guidelines and recommendations as to how to treat HCC patients exist. Staging systems, i.e. the BCLC, have been created to support clinicians in finding the right individualized therapy. However, how does this translate into actual every day practice? Under which circumstances has resection been chosen as the first-line therapy? What are distinct characteristics and tumor features of resected patients as compared to those treated differently? To examine those questions it was essential to systemize and analyze available patient data.

Methods: All patients discussed in the interdisciplinary liver board of the University Clinic Wuerzburg were screened. A total of 217 patients were included and analyzed.

Results: 30% of patients underwent liver resection. Most of them in BCLC stage A (59%) but also in stage B and some even in stage C (almost 8%). They vary significantly from the non-resected patients as sorafenib treatment and best supportive care were reserved for later stages (BCLC C and D) (p = 0.03). However, distribution of the UICC and BCLC stages did not significantly differentiate between primary resection and primary TACE patients (over 90% of patients in both groups in BCLC A and B, p = 0.561). Nevertheless, a primary resection left significantly more patients free of any HCC recurrence than a primary TACE (48% and 15% respectively, p < 0.0001) but less than a primary transplantation (76%, p < 0,0001). No significant differences in the death rates were found between those three groups.

Conclusions: No differences were detected in the number of deaths between resection and transplantation. Thus, resection can be seen as a legitimate alternative taking into account the scarce donor numbers. Both resection and interventional methods (TACE) are valid options in patients with early disease states. Still, resection appears to yield better long-term results as fewer patients suffered from relapsing HCC.