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Surgical Resection for Hepatocellular Carcinoma

Completed
Conditions
Resectable Hepatocellular Carcinoma
Interventions
Procedure: Liver Resection
Registration Number
NCT06013657
Lead Sponsor
Dr Cipto Mangunkusumo General Hospital
Brief Summary

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

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
91
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.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Liver resectionLiver ResectionPatients undergoing liver resection due to hepatocellular carcinoma from 2010 to 2021 in RSCM, Jakarta, an academic tertiary-level national referral hospital in Indonesia.
Primary Outcome Measures
NameTimeMethod
MortalityThrough study completion, an average of 3 years

Mortality status of patients

Secondary Outcome Measures
NameTimeMethod
Child-Pugh classificationWithin one month before surgery

Divided into Chilld-Pugh A,B, and C using clinical (presence of encephalopathy or ascites) and laboratory (prothrombin time, albumin, and bilirubin levels) data.

Segments resectedDuring surgery

1-4 segments

AFP LevelsWithin one month before surgery

Divided into \<400 and \>=400

Largest diameter of tumorWithin one month before surgery

Measured in cm according to imaging

AgeWithin one week before surgery

Age in years

SexWithin one week before surgery

Male or Female

EtiologyWithin one month before surgery

Divided into hepatitis B, hepatitis C, and non-hepatitis in accordance with the laboratory results.

BCLC ClassificationWithin one month before surgery

Divided into Stages 0 and A to D using performance status, child-pugh classification, number and size (in cm) of the tumor.

Number of tumorsWithin one month before surgery

Divided into single and multiple tumors according to imaging findings

CirrhosisWithin one month after surgery

Presence of cirrhosis in histopathological findings

Surgery methodDuring surgery

Laparoscopy or open surgery

Edmondson's gradingWithin one month after surgery

Histopathological grading divided into 1 to 4

Tumor differentiationWithin one month after surgery

Histopathological grading divided well, moderate, moderate to poor, and poor

Length of stayAn average of two weeks

Measured in days from admission to discharge

Trial Locations

Locations (1)

Dr. Cipto Mangunkusumo General Hospital

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Jakarta Pusat, DKI Jakarta, Indonesia

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