{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T04:44:54Z","timestamp":1746333894831},"reference-count":46,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2008,6]]},"abstract":"<jats:p>RACIONAL: O carcinoma hepatocelular \u00e9 uma complica\u00e7\u00e3o que acomete pacientes que apresentam cirrose hep\u00e1tica. A ressec\u00e7\u00e3o hep\u00e1tica, o transplante ortot\u00f3pico de f\u00edgado e a abla\u00e7\u00e3o percut\u00e2nea constituem op\u00e7\u00f5es terap\u00eauticas com o intuito curativo. OBJETIVO: Avaliar os resultados da ressec\u00e7\u00e3o hep\u00e1tica para o tratamento do carcinoma hepatocelular, em f\u00edgados cirr\u00f3ticos, em um hospital geral. M\u00c9TODOS: Foram avaliadas as caracter\u00edsticas cl\u00ednicas, laboratoriais, endosc\u00f3picas e histopatol\u00f3gicas de 22 pacientes submetidos a ressec\u00e7\u00e3o hep\u00e1tica entre os anos de 1996 e 2005, com o intuito de se avaliar a sobrevida, a identifica\u00e7\u00e3o de fatores progn\u00f3sticos e a incid\u00eancia de recidiva tumoral. Para tanto, especial aten\u00e7\u00e3o foi dada aos n\u00edveis s\u00e9ricos de bilirrubinas e alfa-fetoprote\u00edna, grau de disfun\u00e7\u00e3o hepatocelular (avaliado pelas classifica\u00e7\u00f5es Child-Pugh-Turcotte e \" Model for End-Stage Liver Disease\" - MELD), tamanho e n\u00famero de tumores, invas\u00e3o microvascular e presen\u00e7a de les\u00f5es sat\u00e9lites. O n\u00edvel de signific\u00e2ncia utilizado foi de 95% na an\u00e1lise estat\u00edstica. RESULTADOS: A m\u00e9dia de idade dos pacientes estudados foi de 62,09 anos, sendo 17 do sexo masculino. Em 10 casos a cirrose hep\u00e1tica esteve associada \u00e0 infec\u00e7\u00e3o cr\u00f4nica pelo v\u00edrus da hepatite C, em 4 \u00e0 combina\u00e7\u00e3o do uso cr\u00f4nico do etanol e v\u00edrus da hepatite C, em 3 ao v\u00edrus da hepatite B, em 2 ao uso do etanol isoladamente, em 1 com uso de medicamentos e, em 2 casos, n\u00e3o foi identificada a causa. Dezoito pacientes apresentaram tumor \u00fanico, sendo que em 11 o tumor media menos que 5 cm. A sobrevida variou entre 10 dias e 120 meses, com m\u00e9dia de 33,5 meses. No final do 1\u00ba, 3\u00ba e 5\u00ba anos, identificou-se sobrevida de 61,90%, 16,67% e 11,11%, respectivamente. Houve tr\u00eas \u00f3bitos nos primeiros 3 meses posteriores \u00e0 ressec\u00e7\u00e3o hep\u00e1tica. Treze \u00f3bitos foram identificados ap\u00f3s os primeiros 3 meses, sendo que 12 casos foram relacionados \u00e0 recidiva e progress\u00e3o da neoplasia. Um paciente faleceu no per\u00edodo p\u00f3s-operat\u00f3rio imediato de novo procedimento cir\u00fargico para ressec\u00e7\u00e3o de uma recidiva tumoral. No que se refere \u00e0 sobrevida e \u00e0 identifica\u00e7\u00e3o de fatores progn\u00f3sticos, foi identificada rela\u00e7\u00e3o entre sobrevida e invas\u00e3o microvascular. N\u00e3o foi observada diferen\u00e7a, com signific\u00e2ncia estat\u00edstica, nas curvas de sobrevida entre os n\u00edveis s\u00e9ricos de bilirrubinas e alfa-fetoprote\u00edna, grau de disfun\u00e7\u00e3o hepatocelular, tamanho e n\u00famero de les\u00f5es. Entretanto, foi identificada probabilidade de recidiva tumoral maior no grupo de pacientes que apresentava invas\u00e3o microvascular no estudo histopatol\u00f3gico. CONCLUS\u00c3O: Apesar do pequeno n\u00famero de pacientes estudados, observaram-se maus resultados com o tratamento cir\u00fargico do carcinoma hepatocelular. A sele\u00e7\u00e3o adequada dos casos pode ser fator importante para a melhoria desse resultado.<\/jats:p>","DOI":"10.1590\/s0004-28032008000200002","type":"journal-article","created":{"date-parts":[[2008,7,10]],"date-time":"2008-07-10T03:08:07Z","timestamp":1215659287000},"page":"99-105","source":"Crossref","is-referenced-by-count":3,"title":["Avalia\u00e7\u00e3o da ressec\u00e7\u00e3o hep\u00e1tica em pacientes cirr\u00f3ticos com carcinoma hepatocelular"],"prefix":"10.1590","volume":"45","author":[{"given":"Maur\u00edcio","family":"Silva","sequence":"first","affiliation":[{"name":"Santa Casa de Porto Alegre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo Alves de","family":"Mattos","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Faculdade Federal de Ci\u00eancias M\u00e9dicas de Porto Alegre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Roberto Ott","family":"Fontes","sequence":"additional","affiliation":[{"name":"Santa Casa de Porto Alegre; Funda\u00e7\u00e3o Faculdade Federal de Ci\u00eancias M\u00e9dicas de Porto Alegre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e1bio Luiz","family":"Waechter","sequence":"additional","affiliation":[{"name":"Santa Casa de Porto Alegre; Funda\u00e7\u00e3o Faculdade Federal de Ci\u00eancias M\u00e9dicas de Porto Alegre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz","family":"Pereira-Lima","sequence":"additional","affiliation":[{"name":"Santa Casa de Porto Alegre; Funda\u00e7\u00e3o Faculdade Federal de Ci\u00eancias M\u00e9dicas de Porto Alegre"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/0016-5085(95)90450-6","article-title":"Risk factors of intrahepatic recurrence in human small hepatocellular carcinoma","volume":"108","author":"Adachi E","year":"1995","journal-title":"Gastroenterology","ISSN":"http:\/\/id.crossref.org\/issn\/0016-5085","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1097\/01.sla.0000090449.87109.44","article-title":"Liver resection as a bridge to transplantation for hepatocellular carcinoma on cirrhosis: a reasonable strategy?","volume":"238","author":"Adam R","year":"2003","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref3","first-page":"824","article-title":"The \" 50-50 criteria\" on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy","volume":"242","author":"Balzan S","year":"2005","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/S0140-6736(81)90585-7","article-title":"Hepatocellular carcinoma and hepatitis B virus: A prospective study of 22707 men in Taiwan","volume":"21","author":"Beasley RP","year":"1981","journal-title":"Lancet","ISSN":"http:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1097\/01.sla.0000098621.74851.65","article-title":"Resection prior to liver transplantation for hepatocellular carcinoma","volume":"238","author":"Belghiti J","year":"2003","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"s5","DOI":"10.1053\/j.gastro.2004.09.011","article-title":"Primary liver cancer: worldwide incidence and trends","volume":"127","author":"Bosch FX","year":"2004","journal-title":"Gastroenterology","ISSN":"http:\/\/id.crossref.org\/issn\/0016-5085","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S0168-8278(01)00130-1","article-title":"Clinical management of hepatocellular carcinoma: Conclusions of the Barcelona-2000 EASL conference","volume":"35","author":"Bruix J","year":"2001","journal-title":"J Hepatol","ISSN":"http:\/\/id.crossref.org\/issn\/0168-8278","issn-type":"print"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1002\/hep.20933","article-title":"Management of hepatocellular carcinoma: American Association for the Study of Liver Disease AASLD. Practice Guidelines Committee","volume":"42","author":"Bruix J","year":"2005","journal-title":"Hepatology","ISSN":"http:\/\/id.crossref.org\/issn\/0161-0538","issn-type":"print"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.ejso.2005.04.002","article-title":"Liver resection for hepatocellular carcinoma on cirrhosis: analysis of mortality, morbidity and survival - a European single center experience","volume":"31","author":"Capussotti L","year":"2005","journal-title":"Eur J Surg Oncol","ISSN":"http:\/\/id.crossref.org\/issn\/0748-7983","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1053\/ejso.1999.0904","article-title":"Factors affecting survival and long-term outcome in the cirrhotic patient undergoing hepatic resection for hepatocellular carcinoma","volume":"26","author":"Chiappa A","year":"2000","journal-title":"Eur J Surg Oncol","ISSN":"http:\/\/id.crossref.org\/issn\/0748-7983","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1056\/NEJM199903113401001","article-title":"Rising incidence of hepatocellular carcinoma in the united states","volume":"340","author":"El-Serag HB","year":"1999","journal-title":"N Engl J Med","ISSN":"http:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1097\/01.SLA.0000059988.22416.F2","article-title":"Liver resection for hepatocellular carcinoma on cirrhosis: univariate and multivariate analysis of risk factors for intrahepatic recurrence","volume":"237","author":"Ercolani G","year":"2003","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1097\/00000658-199903000-00004","article-title":"Hepatectomy for the hepatocellular carcinoma: toward zero hospital deaths","volume":"229","author":"Fan ST","year":"1999","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1002\/hep.1840200608","article-title":"Prognostic factors of hepatocellular carcinoma in genetic hemochromatosis","volume":"20","author":"Fargion S","year":"1994","journal-title":"Hepatology","ISSN":"http:\/\/id.crossref.org\/issn\/0161-0538","issn-type":"print"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"2886","DOI":"10.1111\/j.1572-0241.2002.07057.x","article-title":"Effect of hepatitis B and C virus infections on the natural history of compensated cirrhosis: a cohort study of 297 patients","volume":"97","author":"Fattovich G","year":"2002","journal-title":"Am J Gastroenterol","ISSN":"http:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref16","series-title":"GLOBOCAN 2000: Cancer incidence, mortality and prevalence worldwide","author":"Ferlay J","year":"2001"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1007\/s00268-005-7768-2","article-title":"Hepatectomy as treatment of choice for hepatocellular carcinoma in elderly patients","volume":"29","author":"Ferrero A","year":"2005","journal-title":"World J Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0364-2313","issn-type":"print"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/j.1399-0012.2004.00196.x","article-title":"Non-resective ablation therapy for hepatocellular carcinoma: effectiveness measured by intention-to-treat and dropout from liver transplant waiting list","volume":"18","author":"Fisher RA","year":"2004","journal-title":"Clin Transpl","ISSN":"http:\/\/id.crossref.org\/issn\/0890-9016","issn-type":"print"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1097\/00000658-199906000-00005","article-title":"An analysis of 412 cases of hepatocellular carcinoma at a Western center","volume":"229","author":"Fong Y","year":"1999","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/0016-5085(90)90296-D","article-title":"Resection of hepatocellular carcinomas: Results in 72 European patients with cirrhosis","volume":"98","author":"Franco D","year":"1990","journal-title":"Gastroenterology","ISSN":"http:\/\/id.crossref.org\/issn\/0016-5085","issn-type":"print"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/00000658-199603000-00011","article-title":"Hepatocellular carcinoma and cirrhosis: Results of surgical treatment in a European series","volume":"223","author":"Fuster J","year":"1996","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/00000658-200107000-00011","article-title":"Improved results of liver resection for hepatocellular carcinoma on cirrhosis give the procedure added value","volume":"234","author":"Grazi GL","year":"2001","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref23","first-page":"68","article-title":"Hepatocellular carcinoma: treatment of 23 cases","volume":"32","author":"Honorio R","year":"1996","journal-title":"Arq Gastroenterol","ISSN":"http:\/\/id.crossref.org\/issn\/0004-2803","issn-type":"print"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0168-8278(02)00360-4","article-title":"Risk factors contributing for early and late phase of intrahepatic recurrence of hepatocellular carcinoma after hepatectomy","volume":"38","author":"Imamura H","year":"2003","journal-title":"J Hepatol","ISSN":"http:\/\/id.crossref.org\/issn\/0168-8278","issn-type":"print"},{"key":"ref25","series-title":"Sleisenger & Fordtran\u2019s gastrointestinal and liver disease:pathology\/diagnosis\/management","first-page":"1364","volume-title":"Hepatic tumors and cysts","author":"Kew MC","year":"1998","edition":"6"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1002\/hep.510300629","article-title":"Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation","volume":"30","author":"Llovet JM","year":"1999","journal-title":"Hepatology","ISSN":"http:\/\/id.crossref.org\/issn\/0161-0538","issn-type":"print"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1136\/gut.50.1.123","article-title":"Cost-effectiveness of adjuvant therapy for hepatocellular carcinoma during the waiting list for liver transplantation","volume":"50","author":"LLovet JM","year":"2002","journal-title":"Gut","ISSN":"http:\/\/id.crossref.org\/issn\/0017-5749","issn-type":"print"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"s134","DOI":"10.1016\/j.jhep.2004.12.010","article-title":"Management of hepatocellular carcinoma in the waiting list before liver transplantation","volume":"42","author":"Majno P","year":"2005","journal-title":"J Hepatol","ISSN":"http:\/\/id.crossref.org\/issn\/0168-8278","issn-type":"print"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJM199603143341104","article-title":"Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis","volume":"334","author":"Mazzaferro V","year":"1996","journal-title":"N Engl J Med","ISSN":"http:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1097\/01.sla.0000143301.56154.95","article-title":"Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study","volume":"240","author":"Mazzaferro V","year":"2004","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref31","first-page":"1281","article-title":"Surgical treatment of hepatocellular carcinoma on cirrhosis: a Western experience","volume":"45","author":"Mazziotti A","year":"1998","journal-title":"Hepatogastroenterology","ISSN":"http:\/\/id.crossref.org\/issn\/0172-6390","issn-type":"print"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1097\/01.sla.0000094549.11754.e6","article-title":"Selection criteria for repeat hepatectomy in patients with recurrent hepatocellular carcinoma","volume":"238","author":"Minagawa M","year":"2003","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref33","first-page":"694","article-title":"Clinical experience with 118 hepatic resections for hepatocellular carcinoma","volume":"99","author":"Nagasue N","year":"1986","journal-title":"Surgery","ISSN":"http:\/\/id.crossref.org\/issn\/0039-6060","issn-type":"print"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1016\/0016-5085(94)90419-7","article-title":"Predictive factors for postoperative recurrence of hepatocellular carcinoma","volume":"106","author":"Okada S","year":"1994","journal-title":"Gastroenterology","ISSN":"http:\/\/id.crossref.org\/issn\/0016-5085","issn-type":"print"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1097\/00000658-200211000-00010","article-title":"Extended hepatic resection for hepatocellular carcinoma in patients with cirrhosis: is it justified?","volume":"236","author":"Poon RT","year":"2002","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/00000658-200107000-00010","article-title":"Improving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years","volume":"234","author":"Poon RT","year":"2001","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/bjs.1800600817","article-title":"Transection of the oesophagus for bleeding oesophageal varices","volume":"60","author":"Pugh RN","year":"1973","journal-title":"Br J Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0007-1323","issn-type":"print"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1002\/lt.20202","article-title":"High pathological risk after resection of recurrence after surgical resection for hepatocellular carcinoma: an indication for salvage liver transplantation","volume":"10","author":"Sala M","year":"2004","journal-title":"Liver Transpl"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1053\/j.gastro.2004.09.039","article-title":"Hepatocellular carcinoma: current surgical management","volume":"127","author":"Song TJ","year":"2004","journal-title":"Gastroenterology","ISSN":"http:\/\/id.crossref.org\/issn\/0016-5085","issn-type":"print"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/S0168-8278(98)80122-0","article-title":"Caracteristics of hepatocellular carcinoma in Italy","volume":"29","author":"Stroffolini T","year":"1998","journal-title":"J Hepatol","ISSN":"http:\/\/id.crossref.org\/issn\/0168-8278","issn-type":"print"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/BF02067120","article-title":"Hepatic resection for hepatocellular carcinoma","volume":"16","author":"Suenaga M","year":"1992","journal-title":"World J Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0364-2313","issn-type":"print"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0002-9610(99)80106-8","article-title":"Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma","volume":"169","author":"Vauthey JN","year":"1995","journal-title":"Am J Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0002-9610","issn-type":"print"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/01.sla.0000129672.51886.44","article-title":"Surgical resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver","volume":"240","author":"Vivarelli M","year":"2004","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1097\/00000658-200205000-00015","article-title":"Preoperative predictors of survival after resection of small hepatocellular carcinomas","volume":"235","author":"Wayne JF","year":"2002","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref45","series-title":"Mortality database"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1002\/1097-0142(20010415)91:8<1479::AID-CNCR1155>3.0.CO;2-0","article-title":"Experience of 1000 patients who underwent hepatectomy for small hepatocellular carcinoma","volume":"91","author":"Zhou XD","year":"2001","journal-title":"Cancer","ISSN":"http:\/\/id.crossref.org\/issn\/0008-543X","issn-type":"print"}],"container-title":["Arquivos de 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