1
|
Yoo JJ, Park DA, Ryoo S, Park J, Choi GH. Comparing laparoscopic and open resection in elderly hepatocellular carcinoma: a systematic review and meta-analysis. J Gastrointest Oncol 2024; 15:1153-1164. [PMID: 38989418 PMCID: PMC11231836 DOI: 10.21037/jgo-24-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/12/2024] [Indexed: 07/12/2024] Open
Abstract
Background Laparoscopic liver resection (LLR) has been accepted as a safe and effective treatment for hepatocellular carcinoma (HCC). However, its impact on elderly patients remains uncertain. This study aimed to compare the efficacy and safety of LLR with open liver resection (OLR) in elderly HCC patients. Methods We conducted a search across the Ovid-Medline, Ovid-EMBASE, and Cochrane Library to identify comparative studies involving primary HCC in elderly patients (≥65 years). Efficacy-related outcomes encompassed overall survival (OS) and disease-free survival (DFS), while safety-related outcomes included post-operative mortality, complications, and length of stay (LOS). Results We identified nine eligible cohort studies comprising 1,599 patients. LLR demonstrated comparable 3- and 5-year DFS [hazard ratio (HR) =1.00, 95% confidence interval (CI): 0.98-1.02; HR =1.02, 95% CI: 0.99-1.05] and 3- and 5-year OS (HR =1.01, 95% CI: 0.99-1.02; HR =1.02, 95% CI: 0.99-1.06, respectively) compared to OLR. In terms of safety, there was no significant difference between LLR and OLR in in-hospital mortality [odds ratio (OR) =0.19; 95% CI: 0.02-1.69], 30-day mortality (OR =0.33; 95% CI: 0.03-3.20), and 90-day mortality (OR =0.70; 95% CI: 0.32-1.53). Additionally, LLR presented fewer overall complications (OR =0.53; 95% CI: 0.41-0.67), a lower rate of major complications (OR =0.51; 95% CI: 0.35-0.74), a reduced incidence of liver failure (OR =0.56; 95% CI: 0.33-0.94), and a shorter LOS compared to OLR (mean difference: -14.47 days). Conclusions LLR exhibited comparable clinical efficacy and superior safety and fewer complications when compared to OLR in elderly patients with HCC requiring surgery.
Collapse
Affiliation(s)
- Jeong-Ju Yoo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Dong Ah Park
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Republic of Korea
| | - Seungeun Ryoo
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Republic of Korea
| | - Jungeun Park
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Republic of Korea
| | - Gi Hong Choi
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
2
|
Pang M, Yang H. Subharmonic scattering of ultrasound contrast agent microbubbles may be an effective and promising tool for portal vein pressure estimation. Hepatobiliary Surg Nutr 2023; 12:625-627. [PMID: 37600993 PMCID: PMC10432296 DOI: 10.21037/hbsn-23-336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023]
Affiliation(s)
- Mingchang Pang
- Department of Liver Surgery, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Huayu Yang
- Department of Liver Surgery, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| |
Collapse
|
3
|
Chen X, Wang D, Dong R, Yang T, Huang B, Cao Y, Lu J, Yin J. Effects of hypersplenism on the outcome of hepatectomy in hepatocellular carcinoma with hepatitis B virus related portal hypertension. Front Surg 2023; 10:1118693. [PMID: 37021093 PMCID: PMC10069649 DOI: 10.3389/fsurg.2023.1118693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/06/2023] [Indexed: 03/22/2023] Open
Abstract
BackgroundAlthough hepatectomy plus splenectomy is not regularly recommended for hepatocellular carcinoma (HCC) with portal hypertension related hypersplenism due to the high risk accompanied with surgical procedures for now. Many researchers still believe that hypersplenism is a controversial adverse prognostic factor for HCC patients. Thus, the primary objective of the study was to determine the effects of hypersplenism on the prognosis of these patients during and after hepatectomy.MethodsA total of 335 patients with HBV-related HCC who underwent surgical resection as primary intervention were included in this study and categorized into three groups. Group A consisted of 226 patients without hypersplenism, Group B included 77 patients with mild hypersplenism, and Group C contained 32 patients with severe hypersplenism. The influence of hypersplenism on the outcome during the perioperative and long-term follow-up periods was analyzed. The independent factors were identified using the Cox proportional hazards regression model.ResultsThe presence of hypersplenism is associated with longer hospital stays, more postoperative blood transfusions, and higher complication rates. The overall survival (OS, P = 0.020) and disease-free survival (DFS, P = 0.005) were significantly decreased in Group B compared to those in Group A. Additionally, the OS (P = 0.014) and DFS (P = 0.005) were reduced in Group C compared to those in Group B. Severe hypersplenism was a significant independent prognostic variable for both OS and DFS.ConclusionSevere hypersplenism prolonged the hospital stay, increased the rate of postoperative blood transfusion, and elevated the incidence of complications. Furthermore, hypersplenism predicted lower overall and disease-free survivals.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Jikai Yin
- Correspondence: Jikai Yin Jianguo Lu
| |
Collapse
|
4
|
Cassese G, Han HS, Lee B, Lee HW, Cho JY, Troisi R. Leaping the Boundaries in Laparoscopic Liver Surgery for Hepatocellular Carcinoma. Cancers (Basel) 2022; 14:2012. [PMID: 35454921 PMCID: PMC9028003 DOI: 10.3390/cancers14082012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 02/08/2023] Open
Abstract
The minimally invasive approach for hepatocellular carcinoma (HCC) had a slower diffusion compared to other surgical fields, mainly due to inherent peculiarities regarding the risks of uncontrollable bleeding, oncological inadequacy, and the need for both laparoscopic and liver major skills. Recently, laparoscopic liver resection (LLR) has been associated with an improved postoperative course, including reduced postoperative decompensation, intraoperative blood losses, length of hospitalization, and unaltered oncological outcomes, leading to its adoption within international guidelines. However, LLR for HCC still faces several limitations, mainly linked to the impaired function of underlying parenchyma, tumor size and numbers, and difficult tumor position. The aim of this review is to highlight the state of the art and future perspectives of LLR for HCC, focusing on key points for overcoming currents limitations and pushing the boundaries in minimally invasive liver surgery (MILS).
Collapse
Affiliation(s)
- Gianluca Cassese
- Department of HPB Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea; (G.C.); (B.L.); (H.W.L.); (J.Y.C.)
- Minimally Invasive and Robotic HPB Surgery Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy;
| | - Ho-Seong Han
- Department of HPB Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea; (G.C.); (B.L.); (H.W.L.); (J.Y.C.)
| | - Boram Lee
- Department of HPB Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea; (G.C.); (B.L.); (H.W.L.); (J.Y.C.)
| | - Hae Won Lee
- Department of HPB Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea; (G.C.); (B.L.); (H.W.L.); (J.Y.C.)
| | - Jai Young Cho
- Department of HPB Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea; (G.C.); (B.L.); (H.W.L.); (J.Y.C.)
| | - Roberto Troisi
- Minimally Invasive and Robotic HPB Surgery Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy;
| |
Collapse
|
5
|
Shen ZF, Liang X. Current status of radical laparoscopy for treating hepatocellular carcinoma with portal hypertension. World J Clin Cases 2021; 9:2419-2432. [PMID: 33889608 PMCID: PMC8040172 DOI: 10.12998/wjcc.v9.i11.2419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/31/2020] [Accepted: 02/01/2021] [Indexed: 02/06/2023] Open
Abstract
The laparoscopic technique is clinically effective in treating hepatocellular carcinoma (HCC) with portal hypertension (PHT). However, existing studies lack systematic arrangement and induction. Here, we review the latest research advancement in laparoscopic technique for treatment of HCC with PHT, based on published literature and our single-institution experience. Our single-center experience reveals no statistical difference in both short- and long-term prognosis of HCC patients after laparoscopic liver resection (LLR), regardless of whether they suffer from PHT, which is consistent with previous studies on the use of LLR for HCC with PHT. Retrieval outcomes indicate existence of short- and long-term prognostic superiority, following laparoscopic treatment, relative to non-laparoscopic treatment. Besides that, LLR offers long-term prognostic advantage compared to laparoscopic radiofrequency ablation. In addition, we review the previous literature and propose corresponding perspectives on the therapy of hypersplenism, the utilization of Pringle maneuver, and the adoption of anatomical hepatectomy during radical laparoscopic treatment. HCC with PHT is not the "forbidden zone" of radical laparoscopic treatment. However, patients’ preoperative liver function should be adequately estimated.
Collapse
Affiliation(s)
- Ze-Feng Shen
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Xiao Liang
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| |
Collapse
|
6
|
Zhang Y, Mao DF, Zhang MW, Fan XX. Clinical value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension. World J Gastroenterol 2017; 23:8044-8052. [PMID: 29259380 PMCID: PMC5725299 DOI: 10.3748/wjg.v23.i45.8044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/30/2017] [Accepted: 09/13/2017] [Indexed: 02/07/2023] Open
Abstract
AIM To explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension, and assess the value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension.
METHODS All 67 patients with liver cirrhosis diagnosed as portal hypertension by hepatic venous pressure gradient in our hospital from June 2014 to December 2014 were enrolled into this study. The baseline information of these patients was recorded. Furthermore, 67 patients were followed-up at 20 mo after treatment, and liver and spleen shear wave velocity were measured by acoustic radiation force impulse at the 1st week, 3rd month and 9th month after treatment. Patients with favorable prognosis were assigned into the favorable prognosis group, while patients with unfavorable prognosis were assigned into the unfavorable prognosis group. The variation and difference in liver and spleen shear wave velocity in these two groups were analyzed by repeated measurement analysis of variance. Meanwhile, in order to evaluate the effect of liver and spleen shear wave velocity on the prognosis of patients with portal hypertension, Cox’s proportional hazard regression model analysis was applied. The ability of those factors in predicting the prognosis of patients with portal hypertension was calculated through receiver operating characteristic (ROC) curves.
RESULTS The liver and spleen shear wave velocity in the favorable prognosis group revealed a clear decline, while those in the unfavorable prognosis group revealed an increasing tendency at different time points. Furthermore, liver and spleen shear wave velocity was higher in the unfavorable prognosis group, compared with the favorable prognosis group; the differences were statistically significant (P < 0.05). The prognosis of patients with portal hypertension was significantly affected by spleen hardness at the 3rd month after treatment [relative risk (RR) = 3.481]. At the 9th month after treatment, the prognosis was affected by liver hardness (RR = 5.241) and spleen hardness (RR = 7.829). The differences between these two groups were statistically significant (P < 0.05). The ROC analysis revealed that the area under the curve (AUC) of spleen hardness at the 3rd month after treatment was 0.644, while the AUCs of liver and spleen hardness at the 9th month were 0.579 and 0.776, respectively. These might predict the prognosis of patients with portal hypertension.
CONCLUSION Spleen hardness at the 3rd month and liver and spleen shear wave velocity at the 9th month may be used to assess the prognosis of patients with portal hypertension. This is hoped to be used as an indicator of predicting the prognosis of patients with portal hypertension.
Collapse
Affiliation(s)
- Yan Zhang
- Department of Interventional Therapy, Second Hospital of Ningbo Municipality, Ningbo 315010, Zhejiang Province, China
| | - Da-Feng Mao
- Department of Interventional Therapy, Second Hospital of Ningbo Municipality, Ningbo 315010, Zhejiang Province, China
| | - Mei-Wu Zhang
- Department of Interventional Therapy, Second Hospital of Ningbo Municipality, Ningbo 315010, Zhejiang Province, China
| | - Xiao-Xiang Fan
- Department of Interventional Therapy, Second Hospital of Ningbo Municipality, Ningbo 315010, Zhejiang Province, China
| |
Collapse
|
7
|
Zhang X, Li C, Wen T, Peng W, Yan L, Yang J. Postoperative Prognostic Nutritional Index Predicts Survival of Patients with Hepatocellular Carcinoma within Milan Criteria and Hypersplenism. J Gastrointest Surg 2017; 21:1626-1634. [PMID: 28523484 DOI: 10.1007/s11605-017-3414-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/26/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND To investigate the predictable value of postprognostic nutritional index (PNI) for patients who are suffering hepatocellular carcinoma (HCC) within Milan criteria and hypersplenism with well-preserved liver function after curative resection. METHODS Patients were divided into two groups: group A (postoperative PNI < 53.05, n = 280) and group B (postoperative PNI ≥ 53.05, n = 109), according to cutoff value of receiver-operating characteristic curve. Clinical data, overall survival (OS), and disease-free survival (DFS) were statistically compared between the two groups, and a multivariate analysis was used to identify prognostic factors. RESULTS The 1-, 3-, 5-, 7-, and 9-year OS of patients in group A were 93.3, 74.2, 53.6, 39.6, and 33.0%, respectively, and 98.9, 89.5, 79.7, 63.9, and 63.9%, respectively, for patients in group B (P = 0.001). The corresponding 1-, 3-, 5-, 7-, and 9-year DFS was 74.1, 51.1, 41.5, 30.1, 24.0, and 83.8, 64.6, 79.7, 54.0, and 49.9% for patients in the two groups, respectively (P = 0.009). Multivariable analysis revealed postoperative PNI as independent predictors of OS (P = 0.004) and DFS (P = 0.007) in patients with HCC within Milan criteria and hypersplenism after liver resection. CONCLUSIONS Postoperative PNI, not preoperative PNI, could predict survival of patients with HCC within Milan criteria and hypersplenism after surgical resection.
Collapse
Affiliation(s)
- Xiaoyun Zhang
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan Province, 610041, China
| | - Chuan Li
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan Province, 610041, China
| | - Tianfu Wen
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan Province, 610041, China.
| | - Wei Peng
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan Province, 610041, China
| | - Lunan Yan
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan Province, 610041, China
| | - Jiayin Yang
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan Province, 610041, China
| |
Collapse
|
8
|
Shen Y, Zhou C, Zhu G, Shi G, Zhu X, Huang C, Zhou J, Fan J, Ding H, Ren N, Sun HC. Liver Stiffness Assessed by Shear Wave Elastography Predicts Postoperative Liver Failure in Patients with Hepatocellular Carcinoma. J Gastrointest Surg 2017; 21:1471-1479. [PMID: 28510795 DOI: 10.1007/s11605-017-3443-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/01/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cirrhosis increases a patient's risk of developing postoperative liver failure (PLF). Liver stiffness (LS), assessed by two-dimensional shear wave elastography (SWE), indicates liver fibrosis with high accuracy. Whether LS is superior to portal hypertension (PHT) in predicting PLF remains to be studied. METHODS The study enrolled 280 patients who underwent hepatectomy for hepatocellular carcinoma from July 2015 to July 2016. All patients received preoperative assessments for LS, PHT, and serum markers of liver fibrosis in addition to other clinicopathological tests. Risk factors for grade A and grade B (or greater) PLF were subjected to univariate and multivariate analysis and receiver operating characteristic curve analysis. RESULTS Fifty-five patients (19.6%) experienced PLF. The cutoff value of LS for predicting cirrhosis was 10.1 kPa. Multivariate analysis identified LS, hyaluronic acid, IV collagen, and the presence of splenomegaly as independent predictors of PLF. The cutoff value of LS for predicting PLF and grade B (or greater) PLF was 11.75 and 11.9 kPa, respectively. LS was superior to PHT in predicting PLF or greater than grade B PLF (0.72 vs. 0.60, 0.76 vs. 0.59, P < 0.05). CONCLUSION LS measured by SWE can predict risk of PLF with greater accuracy than PHT.
Collapse
Affiliation(s)
- Yinghao Shen
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Chenhao Zhou
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Guodong Zhu
- The Third Affiliated Hospital, Nantong University, Nantong, Jiangsu Province, China
| | - Guoming Shi
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Xiaodong Zhu
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Cheng Huang
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Jian Zhou
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Jia Fan
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Hong Ding
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ning Ren
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. .,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China.
| | - Hui-Chuan Sun
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. .,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China.
| |
Collapse
|
9
|
Qi X, Zhang X, Li Z, Hui J, Xiang Y, Chen J, Zhao J, Li J, Qi FZ, Xu Y. HVPG signature: A prognostic and predictive tool in hepatocellular carcinoma. Oncotarget 2016; 7:62789-62796. [PMID: 27566593 PMCID: PMC5308766 DOI: 10.18632/oncotarget.11558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/13/2016] [Indexed: 01/27/2023] Open
Abstract
Hepatic venous pressure gradient (HVPG) measurement provides independent prognostic value in patients with cirrhosis, and the prognostic and predictive role of HVPG in hepatocellular carcinoma (HCC) also has been explored. The management of HCC is limited to the European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD) guidelines that consider that HVPG≥10 mmHg to be a contraindication for hepatic resection (HR), otherwise other treatment modalities are recommended. Current studies show that a raised HVPG diagnosed directly or indirectly leads to a negative prognosis of patients with HCC and cirrhosis, but HVPG greater than 10 mmHg should not be regarded as an absolute contraindication for HR. Selecting direct or surrogate measurement of HVPG is still under debate. Only several studies reported the impact of HVPG in negative prognosis of HCC patients after liver transplantation (LT) and the value of HVPG in the prediction of HCC development, which need to be further validated.
Collapse
Affiliation(s)
- Xiaolong Qi
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xin Zhang
- Department of Radiology, the Fourth People's Hospital of Huai'an, Huai'an, China
| | - Zhijia Li
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jialiang Hui
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yi Xiang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jinjun Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianbo Zhao
- Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Li
- Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai, China
| | - Fu-Zhen Qi
- Department of Hepatopancreatobiliary Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Yong Xu
- Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, China
| |
Collapse
|