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( Choi Kang ),( Cui Gang ),( Youngrok Choi ),( Hyeyoung Kim ),( Suk-won Suh ),( Hae Won Lee ),( Nam-joon Yi ),( Kwang-woong Lee ),( Kyung-suk Suh ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Reviewed the long-term cosmetic outcomes of the different types of wound incision. Methods: 121 Living donors underwent donor hepatectomy for LDLT from September 18th 2006 to December 6th 2013 were included. They were divided into 4 groups according to the incisional types; inverted L upper (n=78 the L group), upper midline (n=35, the U group) and transverse (n=8, the T group). Wound cosmetic outcomes were evaluated mean 458 days after operation using the Vancouver Scar Scale. Results: The T group had better cosmetic outcomes; VSS median of 4.5, 5.0, 6.0 and 7.0 in T, MB, L and U groups respectively. Pigmentation (P=0.153), vascularity (P=0.219), pliability (P=0.336) and wound height (P=0.639) were not different according to the groups. Hypertrophic scarring and Keloids occurrence was lower in T group: 1 (12.5%) in T group, 10 (28.6%) in U group and 19 (24.4%) in L group (P=0.033) (Table 1). The location of scarring was usually in midline incisional site. The distribution of scarring was even in the transverse incision, but it was occurred a little more in the upper 1/3 and the lower 1/3 in midline incision. Conclusions: General long-term cosmetic outcomes were similar following the different minimally invasive incisions. Hypertrophic scar and Keloids occurrence can be decreased in the transverse incision.
( Hyeyoung Kim ),( Sung-woo Ahn ),( Suk Kyun Hong ),( Kyung Chul Yoon ),( Hyo-sin Kim ),( Jin Yong Choi ),( Youngrok Choi ),( Hae Won Lee ),( Nam-joon Yi ),( Kwang-woong Lee ),( Kyung-suk Suh ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Purpose: The recent evidence supporting the survival benefit of liver resection (LR) for Barcelona Clinic Liver Cancer B hepatocellular carcinoma (BCLC-B HCC) is increasing, but remains controversial. Therefore, well designed comparative studies about the results of LR vs. non-surgical treatment for BCLC-B HCC are difficult and still uncommon. The aim of this study was to compare the survival benefit of treatment including LR vs. only non-surgical treatment for BCLC-B HCC between well-matched patient groups. Methods: We reviewed the database of the Korean Liver Cancer Study Group (KLCSG) selected using random sampling from the nationwide multicenter HCC cohort. The registered patients were diagnosed with HCC between 2003 and 2005 (n=4,520) or between 2008 and 2010 (n=4,966). Among the total 887 patients of BCLC-B HCC (multinodular asymptomatic tumors without an invasive pattern), 83 patients underwent LR as the first or second treatment within 2 years after initial diagnosis (LR group; 9.4%). Control was the group of 599 patients who underwent only non-surgical treatment within 2 years after initial diagnosis (non-LR group; 67.5%). To select well-matched patient groups, propensity score matching was used at 1:1 ratio with covariates at the time of diagnosis including registered timing, gender, age, child class, MELD score, tumor number, tumor size, and under lying liver disease. The survival outcomes were compared between the matched groups. Results: The two groups were well balanced by propensity score matching and 80 patients were matched respectively. In LR group, the patients showed significantly better outcome than in non-LR group. The 1-, 2-, 3-, and 5-year overall survivals were 90.1% vs. 78.7%, 87.6% vs. 47.5%, 75.2% vs. 35.1%, and 54.7% vs. 20.2% in LR vs. non-LR group, each (p<0.001). Multivariate Cox proportional hazards regression analysis revealed non-surgical treatments (hazard ratio, 2.974; 95% confidence interval, 1.937 to 4.565, p<0.001), low albumin level (≤3.0 g/dl) at the time of diagnosis (hazard ratio, 2.347; 95% confidence interval, 1.014 to 5.433, p=0.046), and the largest tumor size greater than 5.5cm (hazard ratio, 1.677; 95% confidence interval, 1.109 to 2.535, p=0.014) were significant independent risk factors for overall survival in BCLC-B stage HCC. Conclusion: In BCLC-B stage HCC, treatment with LR offers a significant overall survival benefit compared with non-surgical treatments.