HYPOTHESIS: En bloc partial hepatectomy with inferior vena cava (IVC) resection may be the only curative strategy for @entity1 with @entity99 involving the IVC. DESIGN: Retrospective study. SETTING: Tertiary referral center. @entity1 : All consecutive @entity1 undergoing combined partial hepatectomy with segmental IVC resection and reconstruction between 1990 and 2002. @entity1 with tangential excision of the IVC were excluded. Follow-up was completed by outpatient clinic visits and mail correspondence. MAIN OUTCOME MEASURES: Perioperative outcomes; overall and recurrence-free survival. RESULTS: Nineteen @entity1 (7 @entity1 and 12 @entity1 ) underwent partial hepatectomy and segmental IVC resection and reconstruction. Median age was 59 years (range, 24-74 years). Diagnoses consisted of @entity201 (9 @entity1 ), @entity3 (5 @entity1 ), @entity242 (3 @entity1 ), and @entity157 (2 @entity1 ). Major hepatectomies (>/=3 segments) were performed in 15 @entity1 ; the caudate lobe was resected in 13. @entity99 was used in 13 @entity1 . Ringed polytef grafts were used for IVC reconstruction in all but 1 @entity1 . Transfusion was necessary in 18 @entity1 (median requirement, 5 U). Median operative time was 6.3 hours (range, 3.7-9.0 hours), and hospitalization was 10.5 days (range, 6-41 days). Negative margins of resection were achieved in 16 @entity1 . Complications occurred in 8 @entity1 (42%), including 1 perioperative @entity204 (5%). There was evidence of mural @entity715 of the graft in 2 @entity1 (both nonocclusive); @entity1229 was used postoperatively in 14. Late graft @entity715 was evident in 2 @entity1 . Median overall survival was 38 months (5-year survival, 21%), and recurrence-free survival was 11.5 months (5-year survival, 0%). CONCLUSIONS: @entity1 with large @entity5 involving both the liver and the IVC are candidates for partial hepatectomy and segmental IVC resection. Resection affords the possibility of negative margins, acceptable perioperative morbidity and mortality, long-term graft patency, and prolonged survival.

Is combined partial hepatectomy with segmental resection of inferior vena cava justified for XXXX ?

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'patient', 'PATIENTS', 'men'] @entity242 :: ('MESH:D012509', 'Disease') :: ['sarcoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity201 :: ('MESH:D018281', 'Disease') :: ['cholangiocarcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastatic tumor'] @entity157 :: ('MESH:D006528', 'Disease') :: ['hepatocellular carcinoma'] @entity99 :: ('MESH:D056486', 'Disease') :: ['Hepatic vascular isolation', 'hepatic malignancies'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin sodium']
@entity5 :: (MESH:D009369,Disease) :: ['malignancy']
