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Impact of intermittent portal clamping on the early recurrence of hepatocellular carcinoma after surgery

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Abstract

Purpose

To evaluate the impact of intermittent portal clamping (IPC) during surgery on the early recurrence of hepatocellular carcinoma (HCC).

Methods

The subjects of this retrospective study were 266 patients who underwent curative liver resection for HCC. The patients were grouped as follows: an intermittent portal clamping (IPC) group, n = 78; a continuous portal clamping (CPC) group, n = 128; and a non-portal clamping (NPC) group, n = 60.

Results

The median recurrence-free interval within 2 years of follow-up was significantly shorter in the IPC group (14.2 ± 4.6 months) than in the CPC group (18.0 ± 4.8 months, P = 0.008) or the NPC group (19.04 ± 4.1 months, P = 0.023). Moreover, 2-year recurrence-free survival was much lower in the IPC group than in the CPC group (63.6 vs. 75.8 %, P = 0.025) or the NPC group (63.6 vs. 78.0 %, P = 0.030). However, the 2-year OS rate among the three groups was comparable (72.7 vs. 79.9 %; P = 0.101) and 83.1 %, (P = 0.125). According to univariable analysis, tumor size (>5 cm), tumor number (≥2), tumor grade (low/undifferentiated), TNM stage (III), vascular infiltration, blood transfusion, and IPC were significantly associated with the early postoperative recurrence of HCC. After multivariate analysis, significance of tumor grade (low/undifferentiated) and TNM stage (III) disappeared, whereas tumor size (>5 cm), tumor number (≥2), vascular infiltration, blood transfusion, and IPC remained significant.

Conclusions

IPC is an independent risk factor for the early recurrence of HCC after surgery.

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Abbreviations

HCC:

Hepatocellular carcinoma

IPC:

Intermittent portal clamping

CPC:

Continuous portal clamping

NPC:

Non-portal clamping

RFS:

Recurrence-free survival

OS:

Overall survival

CI:

Confidence interval

RR:

Risk ratio

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China

    Shenghua Hao, Shaofei Chen & Chidan Wan

  2. Department of General Surgery, Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, China

    Xiangwu Yang

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  1. Shenghua Hao
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  2. Shaofei Chen
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Correspondence to Shenghua Hao.

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Dr. Shenghua Hao and other co-authors have no conflict of interest.

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Hao, S., Chen, S., Yang, X. et al. Impact of intermittent portal clamping on the early recurrence of hepatocellular carcinoma after surgery. Surg Today 46, 1290–1295 (2016). https://doi.org/10.1007/s00595-016-1316-6

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  • DOI: https://doi.org/10.1007/s00595-016-1316-6

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