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Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study

The spleen plays an important role in tumor progression and the curative effects of splenectomy before hepatectomy for hypersplenism and hepatocellular carcinoma (HCC) are not clear. We investigated whether splenectomy before hepatectomy increases survival rate among patients with HCC and hypersplen...

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Autores principales: Zhou, Chenyang, Huang, Yueying, Shu, Chang, Zhou, Jiangmin, Hu, Xinsheng, Wang, Jinlin, Wang, Yuwei, Zhang, Zhanguo, Chen, Lin, Chen, Xiaoping, Zhang, Zhiwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850697/
https://www.ncbi.nlm.nih.gov/pubmed/33530224
http://dx.doi.org/10.1097/MD.0000000000024326
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author Zhou, Chenyang
Huang, Yueying
Shu, Chang
Zhou, Jiangmin
Hu, Xinsheng
Wang, Jinlin
Wang, Yuwei
Zhang, Zhanguo
Chen, Lin
Chen, Xiaoping
Zhang, Zhiwei
author_facet Zhou, Chenyang
Huang, Yueying
Shu, Chang
Zhou, Jiangmin
Hu, Xinsheng
Wang, Jinlin
Wang, Yuwei
Zhang, Zhanguo
Chen, Lin
Chen, Xiaoping
Zhang, Zhiwei
author_sort Zhou, Chenyang
collection PubMed
description The spleen plays an important role in tumor progression and the curative effects of splenectomy before hepatectomy for hypersplenism and hepatocellular carcinoma (HCC) are not clear. We investigated whether splenectomy before hepatectomy increases survival rate among patients with HCC and hypersplenism compared with that of patients who underwent synchronous hepatectomy and splenectomy or hepatectomy alone. Between January 2011 and December 2016, 266 patients who underwent hepatectomy as a result of HCC and portal hypertension secondary to hepatitis were retrospectively analyzed. Their perioperative complications and survival outcome were evaluated. Patients underwent synchronous hepatectomy and splenectomy (H-S group) and underwent splenectomy before hepatectomy (H-preS group) exhibited significantly higher disease-free survival (DFS) rates than those of patients underwent hepatectomy alone (H-O group). The DFS rates for patients in the H-S group, H-preS group, and H-O group were 74.6%, 48.4%, 39.8%, and 80.1%, 54.2%, 40.1%, and 60.5%, 30.3%, 13.3%, at 1, 3, and 5 years after surgery, respectively. Tumor size, tumors number, and levels of alpha fetoprotein (AFP) were independent risk factors for DFS. Gender and tumor size were independent prognostic factor for overall survival (OS). The preoperative white blood cell (WBC) and platelet (PLT) counts were significantly higher in the H-preS group than in those of the H-S group and the H-O group. After operation, the WBC and PLT counts in the H-S group and H-preS groups were significantly higher compared to those of the H-O group. No matter splenectomy before hepatectomy or synchronous hepatectomy and splenectomy, hepatectomy with splenectomy may improve DFS rates in patients with HCC and hypersplenism, and splenectomy before hepatectomy alleviates hypersplenism without an increased surgical risk.
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spelling pubmed-78506972021-02-02 Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study Zhou, Chenyang Huang, Yueying Shu, Chang Zhou, Jiangmin Hu, Xinsheng Wang, Jinlin Wang, Yuwei Zhang, Zhanguo Chen, Lin Chen, Xiaoping Zhang, Zhiwei Medicine (Baltimore) 4500 The spleen plays an important role in tumor progression and the curative effects of splenectomy before hepatectomy for hypersplenism and hepatocellular carcinoma (HCC) are not clear. We investigated whether splenectomy before hepatectomy increases survival rate among patients with HCC and hypersplenism compared with that of patients who underwent synchronous hepatectomy and splenectomy or hepatectomy alone. Between January 2011 and December 2016, 266 patients who underwent hepatectomy as a result of HCC and portal hypertension secondary to hepatitis were retrospectively analyzed. Their perioperative complications and survival outcome were evaluated. Patients underwent synchronous hepatectomy and splenectomy (H-S group) and underwent splenectomy before hepatectomy (H-preS group) exhibited significantly higher disease-free survival (DFS) rates than those of patients underwent hepatectomy alone (H-O group). The DFS rates for patients in the H-S group, H-preS group, and H-O group were 74.6%, 48.4%, 39.8%, and 80.1%, 54.2%, 40.1%, and 60.5%, 30.3%, 13.3%, at 1, 3, and 5 years after surgery, respectively. Tumor size, tumors number, and levels of alpha fetoprotein (AFP) were independent risk factors for DFS. Gender and tumor size were independent prognostic factor for overall survival (OS). The preoperative white blood cell (WBC) and platelet (PLT) counts were significantly higher in the H-preS group than in those of the H-S group and the H-O group. After operation, the WBC and PLT counts in the H-S group and H-preS groups were significantly higher compared to those of the H-O group. No matter splenectomy before hepatectomy or synchronous hepatectomy and splenectomy, hepatectomy with splenectomy may improve DFS rates in patients with HCC and hypersplenism, and splenectomy before hepatectomy alleviates hypersplenism without an increased surgical risk. Lippincott Williams & Wilkins 2021-01-29 /pmc/articles/PMC7850697/ /pubmed/33530224 http://dx.doi.org/10.1097/MD.0000000000024326 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle 4500
Zhou, Chenyang
Huang, Yueying
Shu, Chang
Zhou, Jiangmin
Hu, Xinsheng
Wang, Jinlin
Wang, Yuwei
Zhang, Zhanguo
Chen, Lin
Chen, Xiaoping
Zhang, Zhiwei
Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study
title Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study
title_full Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study
title_fullStr Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study
title_full_unstemmed Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study
title_short Splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A retrospective study
title_sort splenectomy before hepatectomy for patients with hepatocellular carcinoma and hypersplenism: a retrospective study
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850697/
https://www.ncbi.nlm.nih.gov/pubmed/33530224
http://dx.doi.org/10.1097/MD.0000000000024326
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