Affiliation:
1. Hepatic Surgery Centre, Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 430030
Abstract
Abstract
Background
The aim of this study was to compare the outcome after simultaneous hepatectomy and splenectomy with that after hepatectomy alone for hepatocellular carcinoma with associated hypersplenism.
Methods
Two hundred and four patients with hepatocellular carcinoma and cirrhotic hypersplenism were divided non-randomly into two groups. Ninety-four underwent simultaneous hepatectomy and splenectomy and 110 underwent hepatectomy alone. White blood cell (WBC) and platelet counts, total serum bilirubin levels, immune function, incidence of complications and 5-year survival rates in the two groups were compared.
Results
WBC and platelet counts, distribution of T cell subsets, and levels of bilirubin, interferon γ and interleukin 2 were different between the two groups after operation. All patients who underwent hepatectomy and splenectomy but only 15·5 per cent of those who had hepatectomy alone completed adjuvant chemotherapy. The 5-year tumour-free survival rate was significantly higher after hepatectomy and splenectomy than after hepatectomy alone (37 versus 27·3 per cent; P = 0·003), although overall survival rates were similar.
Conclusion
Simultaneous hepatectomy and splenectomy was associated with improved 5-year tumour-free survival in patients with hepatocellular carcinoma and hypersplenism.
Funder
Clinical Key Projects of the Ministry of Health China
Publisher
Oxford University Press (OUP)
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