Surgical Resection for Hepatocellular Carcinoma

Study Overview
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Brief Summary
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Hepatocellular carcinoma is a type of liver cancer and is one of the leading causes of global cancer death. Surgical resection of the afflicted areas of the liver is one of the treatment methods for this condition. In this retrospective research, the investigators explore the outcomes of liver resection for hepatocellular carcinoma patients undergoing liver resection from 2010 to 2021 in Cipto Mangunkusumo General Hospital, Jakarta. The main outcome is mortality and the secondary outcomes are factors predicting mortality after resection.

Detailed Description
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Study design This is a retrospective cohort study. Treatment of Hepatocellular Carcinoma Patients in RSCM HCC patients are managed by a multidisciplinary team (MDT) consisting of hepatologists, radiologists, pathologists, radiation oncologists, surgeons, and other specialists related to the patient's condition. Confirmed HCC patients are discussed in a weekly MDT team meeting. The meeting assigned patients to treatment options according to the Barcelona Clinic Liver Center (BCLC) staging system, patient preference, and other clinical considerations. Resection is considered for patients at very early (BCLC 0) or early (BCLC A) HCC stages. This includes CP class A patients with a single tumor or less than three small (<3 cm) tumors. Patients assigned to surgical resection underwent either laparoscopic or open surgery. One to four segments of the liver were removed. Tissue samples were taken for further pathologic examination. Ethical Clearance The ethics committee of The Faculty of Medicine, University of Indonesia, approved this study by giving an ethical clearance with protocol number 19-11-1313. Informed consent was taken from all patients.

Official Title
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Surgical Resection for Hepatocellular Carcinoma: a Single-Center's One Decade of Experience

Conditions
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Resectable Hepatocellular Carcinoma

Intervention / Treatment
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* Procedure: Liver Resection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing liver resection in Cipto Mangunkusumo hospital due to a confirmed diagnosis of hepatocellular carcinoma from 2010 to 2021 Exclusion Criteria: Patients undergoing liver resection in other hospitals were excluded, even though diagnosis or further care is done in Cipto Mangunkusumo hospital Patients with other malignancies Patients undergoing other treatment methods for hepatocellular carcinoma.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Liver resection<br>Patients undergoing liver resection due to hepatocellular carcinoma from 2010 to 2021 in RSCM, Jakarta, an academic tertiary-level national referral hospital in Indonesia. | Procedure: Liver Resection<br>* Resection of a part of the liver afflicted by hepatocellular carcinoma<br>* Other names: Hepatectomy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Mortality status of patients | Through study completion, an average of 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Age | Age in years | Within one week before surgery | 
| Sex | Male or Female | Within one week before surgery | 
| Etiology | Divided into hepatitis B, hepatitis C, and non-hepatitis in accordance with the laboratory results. | Within one month before surgery | 
| Child-Pugh classification | Divided into Chilld-Pugh A,B, and C using clinical (presence of encephalopathy or ascites) and laboratory (prothrombin time, albumin, and bilirubin levels) data. | Within one month before surgery | 
| BCLC Classification | Divided into Stages 0 and A to D using performance status, child-pugh classification, number and size (in cm) of the tumor. | Within one month before surgery | 
| AFP Levels | Divided into <400 and >=400 | Within one month before surgery | 
| Number of tumors | Divided into single and multiple tumors according to imaging findings | Within one month before surgery | 
| Largest diameter of tumor | Measured in cm according to imaging | Within one month before surgery | 
| Surgery method | Laparoscopy or open surgery | During surgery | 
| Segments resected | 1-4 segments | During surgery | 
| Cirrhosis | Presence of cirrhosis in histopathological findings | Within one month after surgery | 
| Edmondson's grading | Histopathological grading divided into 1 to 4 | Within one month after surgery | 
| Tumor differentiation | Histopathological grading divided well, moderate, moderate to poor, and poor | Within one month after surgery | 
| Length of stay | Measured in days from admission to discharge | An average of two weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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carcinoma,hepatocellular, liver neoplasms, hepatectomy, mortality, prognostic