If portal hypertension predicts outcome in cirrhosis, why should this not be the case after surgical resection?

摘要

Surgical resection was the sole therapeutic option for patients with hepatocellular carcinoma until very few years ago. As a consequence, indication of resection was based on technical feasibility. Estimation of operative risk and stratification of long-term survival prediction according to patients' clinical profile was not a major issue as it was assumed that effective resection would always provide better outcome than no treatment. The development of therapeutic options that provide survival benefit, such as transplantation (1), ablation (2), chemoembolization (3) and sorafenib (4), has prompted the need to estimate what would be the outcome for each option (5). According to tumour burden, liver function and physical condition, it is feasible to estimate the survival to be offered by each option and then select the one that would provide the best long-term outcome or at least a similar one with more or less cost and quality of life impairment (6).