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Indication of the Extent of Hepatectomy for Hepatocellular Carcinoma on Cirrhosis by a Simple Algorithm Based on Preoperative Variables—Invited Critique
Christopher D. Anderson, MD;
David C. Linehan, MD
Arch Surg. 2009;144(1):63.
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Paramount to the treatment of patients with low MELD scores with HCC is the question of resection vs listing for liver transplantation with or without bridging therapy. Two previous articles (one from this group) have demonstrated that carefully selected patients with a MELD score of less than 9 can undergo limited liver resection safely.1-2 Cescon and colleagues present data from a 2-center retrospective review of liver resections for HCC in patients with compensated cirrhosis. Their data support using serum sodium levels and MELD scores in combination to make resection decisions for patients with MELD scores of 9 and 10. Algorithms such as this are important aids for therapeutic planning and illustrate that liver resection in patients with MELD scores greater than 9 should be undertaken cautiously. The reader should note that the authors censored all causes of death except liver failure. A . . . [Full Text of this Article]
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Arch Surg. 2009;144(1):57-63.
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