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潜在可切除性肝细胞癌的手术治疗

Authors
Steven A Curley, MD, FACS
Carlton C Barnett, Jr, MD
Eddie K Abdalla, MD
Section Editors
Stanley W Ashley, MD
Kenneth K Tanabe, MD
Deputy Editor
Wenliang Chen, MD, PhD
Translators
苗健, 教授

引言

肝细胞癌(hepatocellular carcinoma ,HCC)是一种生物学高度可变的肿瘤，经常在慢性肝病和肝硬化的情况下发生。该病通常是在其病程晚期确诊的，诊断后的中位生存期约为6-20个月[1]。肝细胞癌主要的潜在可治愈性治疗方法是手术切除，但一些其他的治疗方式也可能有一定作用。对于经恰当选择和准备的患者，肝切除术可能是肝细胞癌的一种治疗方法(即使对于存在基础肝硬化的患者也是如此)。与那些因病变范围而不适合进行其他治疗(包括移植术)的患者相比，接受肝大部分切除术的更晚期疾病患者的结局更好。目前对可进行切除术的早期HCC和基础肝病患者越来越多地考虑进行移植术，因为这种治疗方式使患者的无病生存期及基础肝病的缓解可能更好，但该治疗受到器官可用性的限制(尤其是在可进行切除治疗的患者中)。

手术切除的选择部分取决于基础肝病的严重程度，后者是通过Child-Pugh分级(表 1)或终末期肝病模型评分(Model for End-stage Liver Disease, MELD)反应的；MELD是一个前瞻性开发且得到验证的慢性肝病严重程度评分系统，可用于预测生存期(计算器 1)。 (参见“肝病患者手术风险评估”，关于‘MELD评分’一节和“终末期肝病模型(MELD)”)

本文将总结HCC的手术切除。HCC的临床表现和诊断、HCC治疗方法的概述、非手术性局部消融方案、肝移植、辅助治疗和新辅助治疗见其他专题。

●(参见“肝细胞癌的流行病学和病因学关联”)

●(参见“肝细胞癌治疗方法的概述”)

                

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References
Top
  1. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients: the Cancer of the Liver Italian Program (CLIP) investigators. Hepatology 1998; 28:751.
  2. Yopp AC, Mansour JC, Beg MS, et al. Establishment of a multidisciplinary hepatocellular carcinoma clinic is associated with improved clinical outcome. Ann Surg Oncol 2014; 21:1287.
  3. Bruix J. Treatment of hepatocellular carcinoma. Hepatology 1997; 25:259.
  4. Vauthey JN, Klimstra D, Franceschi D, et al. Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma. Am J Surg 1995; 169:28.
  5. Bruix J, Castells A, Bosch J, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology 1996; 111:1018.
  6. Pawlik TM, Poon RT, Abdalla EK, et al. Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg 2005; 140:450.
  7. Roayaie S, Jibara G, Taouli B, Schwartz M. Resection of hepatocellular carcinoma with macroscopic vascular invasion. Ann Surg Oncol 2013; 20:3754.
  8. Lo CM, Lai EC, Liu CL, et al. Laparoscopy and laparoscopic ultrasonography avoid exploratory laparotomy in patients with hepatocellular carcinoma. Ann Surg 1998; 227:527.
  9. Fong Y, Sun RL, Jarnagin W, Blumgart LH. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg 1999; 229:790.
  10. Minagawa M, Ikai I, Matsuyama Y, et al. Staging of hepatocellular carcinoma: assessment of the Japanese TNM and AJCC/UICC TNM systems in a cohort of 13,772 patients in Japan. Ann Surg 2007; 245:909.
  11. Makuuchi M, Sano K. The surgical approach to HCC: our progress and results in Japan. Liver Transpl 2004; 10:S46.
  12. Murakami T, Kim T, Kawata S, et al. Evaluation of optimal timing of arterial phase imaging for the detection of hypervascular hepatocellular carcinoma by using triple arterial phase imaging with multidetector-row helical computed tomography. Invest Radiol 2003; 38:497.
  13. Iannaccone R, Laghi A, Catalano C, et al. Hepatocellular carcinoma: role of unenhanced and delayed phase multi-detector row helical CT in patients with cirrhosis. Radiology 2005; 234:460.
  14. Laghi A, Iannaccone R, Rossi P, et al. Hepatocellular carcinoma: detection with triple-phase multi-detector row helical CT in patients with chronic hepatitis. Radiology 2003; 226:543.
  15. Rode A, Bancel B, Douek P, et al. Small nodule detection in cirrhotic livers: evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver. J Comput Assist Tomogr 2001; 25:327.
  16. Burrel M, Llovet JM, Ayuso C, et al. MRI angiography is superior to helical CT for detection of HCC prior to liver transplantation: an explant correlation. Hepatology 2003; 38:1034.
  17. Kim YK, Kim CS, Chung GH, et al. Comparison of gadobenate dimeglumine-enhanced dynamic MRI and 16-MDCT for the detection of hepatocellular carcinoma. AJR Am J Roentgenol 2006; 186:149.
  18. National Comprehensive Cancer Network (NCCN). NCCN Clinical practice guidelines in oncology. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp (Accessed on February 27, 2016).
  19. Andreou A, Vauthey JN, Cherqui D, et al. Improved long-term survival after major resection for hepatocellular carcinoma: a multicenter analysis based on a new definition of major hepatectomy. J Gastrointest Surg 2013; 17:66.
  20. Yang LY, Fang F, Ou DP, et al. Solitary large hepatocellular carcinoma: a specific subtype of hepatocellular carcinoma with good outcome after hepatic resection. Ann Surg 2009; 249:118.
  21. Vauthey JN, Lauwers GY, Esnaola NF, et al. Simplified staging for hepatocellular carcinoma. J Clin Oncol 2002; 20:1527.
  22. Nagasue N, Kohno H, Chang YC, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg 1993; 217:375.
  23. Pandey D, Lee KH, Wai CT, et al. Long term outcome and prognostic factors for large hepatocellular carcinoma (10 cm or more) after surgical resection. Ann Surg Oncol 2007; 14:2817.
  24. Hanazaki K, Kajikawa S, Shimozawa N, et al. Hepatic resection for large hepatocellular carcinoma. Am J Surg 2001; 181:347.
  25. Hanazaki K, Kajikawa S, Shimozawa N, et al. Hepatic resection for hepatocellular carcinoma in diameter of > or = 10 cm. Hepatogastroenterology 2002; 49:518.
  26. Lee NH, Chau GY, Lui WY, et al. Surgical treatment and outcome in patients with a hepatocellular carcinoma greater than 10 cm in diameter. Br J Surg 1998; 85:1654.
  27. Yeh CN, Lee WC, Chen MF. Hepatic resection and prognosis for patients with hepatocellular carcinoma larger than 10 cm: two decades of experience at Chang Gung memorial hospital. Ann Surg Oncol 2003; 10:1070.
  28. Liau KH, Ruo L, Shia J, et al. Outcome of partial hepatectomy for large (> 10 cm) hepatocellular carcinoma. Cancer 2005; 104:1948.
  29. Ariizumi S, Kotera Y, Takahashi Y, et al. Impact of hepatectomy for huge solitary hepatocellular carcinoma. J Surg Oncol 2013; 107:408.
  30. Shrager B, Jibara GA, Tabrizian P, et al. Resection of large hepatocellular carcinoma (≥10 cm): a unique western perspective. J Surg Oncol 2013; 107:111.
  31. Allemann P, Demartines N, Bouzourene H, et al. Long-term outcome after liver resection for hepatocellular carcinoma larger than 10 cm. World J Surg 2013; 37:452.
  32. Chang YJ, Chung KP, Chang YJ, Chen LJ. Long-term survival of patients undergoing liver resection for very large hepatocellular carcinomas. Br J Surg 2016; 103:1513.
  33. Poon RT, Fan ST. Evaluation of the new AJCC/UICC staging system for hepatocellular carcinoma after hepatic resection in Chinese patients. Surg Oncol Clin N Am 2003; 12:35.
  34. Lei HJ, Chau GY, Lui WY, et al. Prognostic value and clinical relevance of the 6th Edition 2002 American Joint Committee on Cancer staging system in patients with resectable hepatocellular carcinoma. J Am Coll Surg 2006; 203:426.
  35. Ercolani G, Grazi GL, Ravaioli M, et al. The role of lymphadenectomy for liver tumors: further considerations on the appropriateness of treatment strategy. Ann Surg 2004; 239:202.
  36. Sun HC, Zhuang PY, Qin LX, et al. Incidence and prognostic values of lymph node metastasis in operable hepatocellular carcinoma and evaluation of routine complete lymphadenectomy. J Surg Oncol 2007; 96:37.
  37. Dodd GD 3rd, Baron RL, Oliver JH 3rd, et al. Enlarged abdominal lymph nodes in end-stage cirrhosis: CT-histopathologic correlation in 507 patients. Radiology 1997; 203:127.
  38. Kobayashi S, Takahashi S, Kato Y, et al. Surgical treatment of lymph node metastases from hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 2011; 18:559.
  39. Xiaohong S, Huikai L, Feng W, et al. Clinical significance of lymph node metastasis in patients undergoing partial hepatectomy for hepatocellular carcinoma. World J Surg 2010; 34:1028.
  40. Hashimoto M, Matsuda M, Watanabe G. Metachronous resection of metastatic lymph nodes in patients with hepatocellular carcinoma. Hepatogastroenterology 2009; 56:788.
  41. Grobmyer SR, Wang L, Gonen M, et al. Perihepatic lymph node assessment in patients undergoing partial hepatectomy for malignancy. Ann Surg 2006; 244:260.
  42. Recordare A, Bonariol L, Caratozzolo E, et al. Management of spontaneous bleeding due to hepatocellular carcinoma. Minerva Chir 2002; 57:347.
  43. Hsueh KC, Fan HL, Chen TW, et al. Management of spontaneously ruptured hepatocellular carcinoma and hemoperitoneum manifested as acute abdomen in the emergency room. World J Surg 2012; 36:2670.
  44. Mise Y, Imamura H, Hashimoto T, et al. Cohort study of the survival benefit of resection for recurrent hepatic and/or pulmonary metastases after primary hepatectomy for colorectal metastases. Ann Surg 2010; 251:902.
  45. Lang BH, Poon RT, Fan ST, Wong J. Influence of laparoscopy on postoperative recurrence and survival in patients with ruptured hepatocellular carcinoma undergoing hepatic resection. Br J Surg 2004; 91:444.
  46. Liu CL, Fan ST, Lo CM, et al. Management of spontaneous rupture of hepatocellular carcinoma: single-center experience. J Clin Oncol 2001; 19:3725.
  47. Marini P, Vilgrain V, Belghiti J. Management of spontaneous rupture of liver tumours. Dig Surg 2002; 19:109.
  48. Takebayashi T, Kondo S, Ambo Y, et al. Staged hepatectomy following arterial embolization for ruptured hepatocellular carcinoma. Hepatogastroenterology 2002; 49:1074.
  49. Yeh CN, Lee WC, Jeng LB, et al. Spontaneous tumour rupture and prognosis in patients with hepatocellular carcinoma. Br J Surg 2002; 89:1125.
  50. Huang JF, Wu SM, Wu TH, et al. Liver resection for complicated hepatocellular carcinoma: challenges but opportunity for long-term survivals. J Surg Oncol 2012; 106:959.
  51. Aoki T, Kokudo N, Matsuyama Y, et al. Prognostic impact of spontaneous tumor rupture in patients with hepatocellular carcinoma: an analysis of 1160 cases from a nationwide survey. Ann Surg 2014; 259:532.
  52. Colleoni M, Audisio RA, De Braud F, et al. Practical considerations in the treatment of hepatocellular carcinoma. Drugs 1998; 55:367.
  53. Imamura H, Seyama Y, Kokudo N, et al. One thousand fifty-six hepatectomies without mortality in 8 years. Arch Surg 2003; 138:1198.
  54. Bismuth H, Majno PE, Adam R. Liver transplantation for hepatocellular carcinoma. Semin Liver Dis 1999; 19:311.
  55. Abdalla EK, Hicks ME, Vauthey JN. Portal vein embolization: rationale, technique and future prospects. Br J Surg 2001; 88:165.
  56. Farges O, Belghiti J, Kianmanesh R, et al. Portal vein embolization before right hepatectomy: prospective clinical trial. Ann Surg 2003; 237:208.
  57. Liver Cancer Study Group of Japan. The general rules for the clinical and pathological study of primary liver cancer (in Japanese), 4th ed, Kanehara and Co, Tokyo.
  58. Imamura H, Shimada R, Kubota M, et al. Preoperative portal vein embolization: an audit of 84 patients. Hepatology 1999; 29:1099.
  59. Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg 2008; 247:49.
  60. Yoo H, Kim JH, Ko GY, et al. Sequential transcatheter arterial chemoembolization and portal vein embolization versus portal vein embolization only before major hepatectomy for patients with hepatocellular carcinoma. Ann Surg Oncol 2011; 18:1251.
  61. Leung U, Simpson AL, Araujo RL, et al. Remnant growth rate after portal vein embolization is a good early predictor of post-hepatectomy liver failure. J Am Coll Surg 2014; 219:620.
  62. Palavecino M, Chun YS, Madoff DC, et al. Major hepatic resection for hepatocellular carcinoma with or without portal vein embolization: Perioperative outcome and survival. Surgery 2009; 145:399.
  63. Ogata S, Belghiti J, Farges O, et al. Sequential arterial and portal vein embolizations before right hepatectomy in patients with cirrhosis and hepatocellular carcinoma. Br J Surg 2006; 93:1091.
  64. Wu CC, Ho YZ, Ho WL, et al. Preoperative transcatheter arterial chemoembolization for resectable large hepatocellular carcinoma: a reappraisal. Br J Surg 1995; 82:122.
  65. Sasaki A, Iwashita Y, Shibata K, et al. Preoperative transcatheter arterial chemoembolization reduces long-term survival rate after hepatic resection for resectable hepatocellular carcinoma. Eur J Surg Oncol 2006; 32:773.
  66. Meric F, Patt YZ, Curley SA, et al. Surgery after downstaging of unresectable hepatic tumors with intra-arterial chemotherapy. Ann Surg Oncol 2000; 7:490.
  67. Zhong C, Guo RP, Li JQ, et al. A randomized controlled trial of hepatectomy with adjuvant transcatheter arterial chemoembolization versus hepatectomy alone for Stage III A hepatocellular carcinoma. J Cancer Res Clin Oncol 2009; 135:1437.
  68. Harada T, Matsuo K, Inoue T, et al. Is preoperative hepatic arterial chemoembolization safe and effective for hepatocellular carcinoma? Ann Surg 1996; 224:4.
  69. Uchida M, Kohno H, Kubota H, et al. Role of preoperative transcatheter arterial oily chemoembolization for resectable hepatocellular carcinoma. World J Surg 1996; 20:326.
  70. Fan J, Tang ZY, Yu YQ, et al. Improved survival with resection after transcatheter arterial chemoembolization (TACE) for unresectable hepatocellular carcinoma. Dig Surg 1998; 15:674.
  71. Lee KT, Lu YW, Wang SN, et al. The effect of preoperative transarterial chemoembolization of resectable hepatocellular carcinoma on clinical and economic outcomes. J Surg Oncol 2009; 99:343.
  72. Aoki T, Imamura H, Hasegawa K, et al. Sequential preoperative arterial and portal venous embolizations in patients with hepatocellular carcinoma. Arch Surg 2004; 139:766.
  73. Montorsi M, Santambrogio R, Bianchi P, et al. Laparoscopy with laparoscopic ultrasound for pretreatment staging of hepatocellular carcinoma: a prospective study. J Gastrointest Surg 2001; 5:312.
  74. Makuuchi M, Hasegawa H, Yamazaki S, et al. The use of operative ultrasound as an aid to liver resection in patients with hepatocellular carcinoma. World J Surg 1987; 11:615.
  75. Bismuth H, Castaing D, Garden OJ. The use of operative ultrasound in surgery of primary liver tumors. World J Surg 1987; 11:610.
  76. Regimbeau JM, Kianmanesh R, Farges O, et al. Extent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma. Surgery 2002; 131:311.
  77. Gonzalez RJ, Barnett CC Jr. A technique for safely teaching major hepatectomy to surgical residents. Am J Surg 2008; 195:521.
  78. Torzilli G, Procopio F, Donadon M, et al. Anatomical right posterior sectionectomy: a further expansion of the ultrasound-guided compression technique. Updates Surg 2011; 63:91.
  79. Takayama T, Makuuchi M, Watanabe K, et al. A new method for mapping hepatic subsegment: counterstaining identification technique. Surgery 1991; 109:226.
  80. Donadon M, Torzilli G. Intraoperative ultrasound in patients with hepatocellular carcinoma: from daily practice to future trends. Liver Cancer 2013; 2:16.
  81. Tomimaru Y, Eguchi H, Marubashi S, et al. Equivalent outcomes after anatomical and non-anatomical resection of small hepatocellular carcinoma in patients with preserved liver function. Dig Dis Sci 2012; 57:1942.
  82. Marubashi S, Gotoh K, Akita H, et al. Anatomical versus non-anatomical resection for hepatocellular carcinoma. Br J Surg 2015; 102:776.
  83. Liu CL, Fan ST, Cheung ST, et al. Anterior approach versus conventional approach right hepatic resection for large hepatocellular carcinoma: a prospective randomized controlled study. Ann Surg 2006; 244:194.
  84. Ishizawa T, Kokudo N, Makuuchi M. Right hepatectomy for hepatocellular carcinoma: is the anterior approach superior to the conventional approach? Ann Surg 2008; 247:390.
  85. Belghiti J, Guevara OA, Noun R, et al. Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization. J Am Coll Surg 2001; 193:109.
  86. Rui JA, Wang SB, Chen SG, Zhou L. Right trisectionectomy for primary liver cancer. World J Gastroenterol 2003; 9:706.
  87. Wei AC, Tung-Ping Poon R, Fan ST, Wong J. Risk factors for perioperative morbidity and mortality after extended hepatectomy for hepatocellular carcinoma. Br J Surg 2003; 90:33.
  88. Melendez J, Ferri E, Zwillman M, et al. Extended hepatic resection: a 6-year retrospective study of risk factors for perioperative mortality. J Am Coll Surg 2001; 192:47.
  89. Mehrabi A, Mood ZA, Roshanaei N, et al. Mesohepatectomy as an option for the treatment of central liver tumors. J Am Coll Surg 2008; 207:499.
  90. Scudamore CH, Buczkowski AK, Shayan H, et al. Mesohepatectomy. Am J Surg 2000; 179:356.
  91. Hu RH, Lee PH, Chang YC, et al. Treatment of centrally located hepatocellular carcinoma with central hepatectomy. Surgery 2003; 133:251.
  92. Jacobs M, McDonough J, ReMine SG. Resection of central hepatic malignant lesions. Am Surg 2003; 69:186.
  93. Wu CC, Ho WL, Chen JT, et al. Mesohepatectomy for centrally located hepatocellular carcinoma: an appraisal of a rare procedure. J Am Coll Surg 1999; 188:508.
  94. Chen XP, Qiu FZ, Lau WY, et al. Mesohepatectomy for hepatocellular carcinoma: a study of 256 patients. Int J Colorectal Dis 2008; 23:543.
  95. Lang H, Sotiropoulos GC, Malagó M, Broelsch CE. Mesohepatectomy, caudate lobectomy and resection of hilar bifurcation with biliary reconstruction by 6 hepaticojejunostomies for Klatskin tumor. Hepatogastroenterology 2003; 50:1327.
  96. de'Angelis N, Pascal G, Salloum C, et al. Central Hepatectomy versus Extended Hepatectomy for Malignant Tumors: A Propensity Score Analysis of Postoperative Complications. World J Surg 2016; 40:2745.
  97. Buell JF, Thomas MT, Rudich S, et al. Experience with more than 500 minimally invasive hepatic procedures. Ann Surg 2008; 248:475.
  98. Cho JY, Han HS, Yoon YS, Shin SH. Experiences of laparoscopic liver resection including lesions in the posterosuperior segments of the liver. Surg Endosc 2008; 22:2344.
  99. Chen HY, Juan CC, Ker CG. Laparoscopic liver surgery for patients with hepatocellular carcinoma. Ann Surg Oncol 2008; 15:800.
  100. Belli G, Fantini C, D'Agostino A, et al. Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis: short- and middle-term results. Surg Endosc 2007; 21:2004.
  101. Dagher I, Lainas P, Carloni A, et al. Laparoscopic liver resection for hepatocellular carcinoma. Surg Endosc 2008; 22:372.
  102. Cherqui D, Laurent A, Tayar C, et al. Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives. Ann Surg 2006; 243:499.
  103. Vibert E, Perniceni T, Levard H, et al. Laparoscopic liver resection. Br J Surg 2006; 93:67.
  104. Dagher I, O'Rourke N, Geller DA, et al. Laparoscopic major hepatectomy: an evolution in standard of care. Ann Surg 2009; 250:856.
  105. Yin Z, Fan X, Ye H, et al. Short- and long-term outcomes after laparoscopic and open hepatectomy for hepatocellular carcinoma: a global systematic review and meta-analysis. Ann Surg Oncol 2013; 20:1203.
  106. Han HS, Shehta A, Ahn S, et al. Laparoscopic versus open liver resection for hepatocellular carcinoma: Case-matched study with propensity score matching. J Hepatol 2015; 63:643.
  107. Belghiti J, Cortes A, Abdalla EK, et al. Resection prior to liver transplantation for hepatocellular carcinoma. Ann Surg 2003; 238:885.
  108. Vitali GC, Laurent A, Terraz S, et al. Minimally invasive surgery versus percutaneous radio frequency ablation for the treatment of single small (≤3 cm) hepatocellular carcinoma: a case-control study. Surg Endosc 2016; 30:2301.
  109. Liu L, Wang Z, Jiang S, et al. Perioperative allogenenic blood transfusion is associated with worse clinical outcomes for hepatocellular carcinoma: a meta-analysis. PLoS One 2013; 8:e64261.
  110. Nanashima A, Yamaguchi H, Shibasaki S, et al. Comparative analysis of postoperative morbidity according to type and extent of hepatectomy. Hepatogastroenterology 2005; 52:844.
  111. Nathan H, Schulick RD, Choti MA, Pawlik TM. Predictors of survival after resection of early hepatocellular carcinoma. Ann Surg 2009; 249:799.
  112. Wayne JD, Lauwers GY, Ikai I, et al. Preoperative predictors of survival after resection of small hepatocellular carcinomas. Ann Surg 2002; 235:722.
  113. Schemmer P, Friess H, Hinz U, et al. Stapler hepatectomy is a safe dissection technique: analysis of 300 patients. World J Surg 2006; 30:419.
  114. Cottone M, Virdone R, Fusco G, et al. Asymptomatic hepatocellular carcinoma in Child's A cirrhosis. A comparison of natural history and surgical treatment. Gastroenterology 1989; 96:1566.
  115. Chen MF, Jeng LB. Partial hepatic resection for hepatocellular carcinoma. J Gastroenterol Hepatol 1997; 12:S329.
  116. Bismuth H, Houssin D, Ornowski J, Meriggi F. Liver resections in cirrhotic patients: a Western experience. World J Surg 1986; 10:311.
  117. Takenaka K, Kanematsu T, Fukuzawa K, Sugimachi K. Can hepatic failure after surgery for hepatocellular carcinoma in cirrhotic patients be prevented? World J Surg 1990; 14:123.
  118. Mullen JT, Ribero D, Reddy SK, et al. Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg 2007; 204:854.
  119. Vauthey JN, Pawlik TM, Ribero D, et al. Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol 2006; 24:2065.
  120. Li Y, Ruan DY, Yi HM, et al. A three-factor preoperative scoring model predicts risk of recurrence after liver resection or transplantation in hepatocellular carcinoma patients with preserved liver function. Hepatobiliary Pancreat Dis Int 2015; 14:477.
  121. Dekervel J, Popovic D, van Malenstein H, et al. A Global Risk Score (GRS) to Simultaneously Predict Early and Late Tumor Recurrence Risk after Resection of Hepatocellular Carcinoma. Transl Oncol 2016; 9:139.