Surgical treatment of hepatocellular carcinoma in cirrhotic patients.
Launois, B.; Chauvin, J.; Machado, M.A.C. ; Bourdonnec, P.; Campion, J.P.; Bardaxoglou, E.
Ann. Gastroentérol. Hépatol. 32(1): 35-40, 1996.



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From April 1978 to February 1992, 74 patients were operated on at the surgical clinic of University Medical Center of Rennes (35000) France . There were 60 hepatectomies and 14 transplantations. The mean age was 60.2 years ± 9 years and the sex ratio : 70 males and 4 females. The etiology was alcoholic in 43 patients (58%) , post hepatitis (B and C) in 22 patients (30%) and due to hemochromatosis in 9 patients (12%). According to the Child-Pugh classification, 48 patients were Child A, 11 Child B and one Child C in hepatectomy group and 9 patients Child A and 5 patients Child B in transplantation group. The operative mortality was 10% in hepatectomy group and 35.7% in liver transplantation group. Overall survival was 61.8% at 1 year, 47.1% at 2 years, 38.2% at 3 years and 20% at 5 years. 5 years survival is 21.4% after transplantation and 18.5% after resection. This difference is not significant. In conclusion, according to 5 years survival and to operative mortality the treatment of choice is hepatectomy in HCC in cirrhotic patients. However the best treatment is the prevention of cirrhosis.