Re-evaluation of the predictive score for 6-month graft survival in living donor liver transplantation in the modern era.

The limitations of donor age, graft size, and the Model for End-Stage Liver Disease (MELD) score have not been apparent in living donor liver transplantation (LDLT). Our team developed a formula for predicting graft survival after LDLT; the formula includes the graft weight, donor age, MELD score, and portosystemic shunt status. The aims of this study were to re-evaluate the reliability of our formula and to assess whether our modified treatment strategy has improved 6-month graft survival.

Trends in surgical results of hepatic resection for hepatocellular carcinoma: 1,000 consecutive cases over 20 years in a single institution.

Background: Surgical results have been reported to be improved in hepatic resections for hepatocellular carcinoma (HCC) in recent years, but the detailed trends in surgical results for HCC in a single high-volume center are still not clear.

Methods: Surgical results in 1,000 hepatic resections for HCC performed at a single medical center from 1989 to 2011 were analyzed. Patients were divided into 3 groups: those performed in the early period (1989 to 1995, n = 181), the middle period (1996 to 2004, n = 391), and the late period (2005 to 2011, n = 428).

Prognostic factors affecting survival at recurrence of hepatocellular carcinoma after living-donor liver transplantation: with special reference to neutrophil/lymphocyte ratio.

Background: In living-donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC), it is important to predict not only who may be susceptible to recurrence but also who may survive longer. The neutrophil/lymphocyte ratio (NLR) is useful to properly assess the patient without decreasing the long-term survival after LDLT. In this study, we investigated the relationship between NLR and prognosis of patients with recurrent HCC after LDLT.

A "rendezvous technique" for treating a pancreatic fistula after distal pancreatectomy.

Background: Pancreatic fistulae are a major complication of distal pancreatectomy (DP). Some cases of severe pancreatic fistula require invasive procedures. There have been some reports concerning the effectiveness of pancreatic duct drainage through an endoscopic transpapillary approach for pancreatic fistulae.

Second hepatectomy for recurrent hepatocellular carcinoma achieved sustained virological response to interferon therapy for hepatitis C.

Background/aims: Interferon (IFN) improves the prognosis of HCV-related hepatocellular carcinoma (HCC) in patients. However, the effects of IFN therapy for second hepatectomy (Hx) for recurrent HCC have not been established.

Methodology: Subjects included 96 patients who underwent a second Hx for recurrence of HCV-related HCC.

Third or more repeat hepatectomy for recurrent hepatocellular carcinoma.

Background: We sought to evaluate the surgical results of third or more repeat hepatectomy for recurrent hepatocellular carcinoma (HCC). The role of repeat hepatectomy for recurrent HCC, especially in cases with third or more repeat hepatectomy, is controversial.

Methods: We performed A retrospective, cohort study to analyze the surgical results of repeat hepatectomy performed at a single medical center from 1989 to 2011.

Pathological analysis of opened round ligaments as venous patch grafts in living donor liver transplantation.

Although the round ligament, including the umbilical vein, could be used as a venous graft in living donor liver transplantation (LDLT), no studies have determined its appropriate use on the basis of pathological findings. We prospectively examined 19 LDLT cases in which the donor's round ligament was procured and used as a venous graft. The round ligaments were categorized into 3 types based on the CD31 immunohistochemistry of tissue cross-sections: (I) canalized umbilical veins (n = 7 or 36.

Preoperative neutrophil-to-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma: a retrospective analysis.

Objective: To clarify the prognostic value of the preoperative blood neutrophil-to-lymphocyte ratio (NLR) in patients undergoing hepatectomy for hepatocellular carcinoma (HCC).

Background: Although a high NLR has been reported to be a predictor of poor survival in patients with various cancers, it has not been extensively examined in patients with HCC.

Methods: This retrospective study enrolled 958 patients who underwent hepatectomy without preoperative therapy for HCC from 1996 to 2009.

Skeletal muscle area correlates with body surface area in healthy adults.

Aim: Depletion of skeletal muscle mass (sarcopenia) predicts survival in patients with cancer or liver cirrhosis. Recently, many reports have used computed tomography (CT) to measure muscle area to define sarcopenia. However, the definition of sarcopenia using CT has not been fully determined.

CD4 T cell-mediated masking effects of the immunogenicity of tumor-associated antigens are qualitatively and quantitatively different depending on the individual antigens.

The use of cancer immunotherapy as part of multidisciplinary therapies for cancer is a promising strategy for the cure of advanced cancer patients. In cancer immunotherapy, the effective priming of tumor-associated antigen (TAA)-specific CD8+ T cells is essential, and therefore, the appropriate selection of the best peptide for targeting the cancer is a most important concern. One criticism in the selection of a TAA is the immunogenicity of the TAA, the vaccination of which effectively elicits clinical responses.

Obstructing spontaneous major shunt vessels is mandatory to keep adequate portal inflow in living-donor liver transplantation.

Background: It has not been addressed whether the major spontaneous portosystemic shunt vessels should be ligated in living-donor liver transplantation (LDLT).

Methods: We performed a retrospective analysis of 324 cases of adult-to-adult LDLT.

Results: Factors associated with the presence of major (>10 mm) shunt vessels (n=130) included portal vein (PV) thrombosis (27.

Risk factors for recurrence after curative resection of hepatitis C-related hepatocellular carcinoma in patients without postoperative interferon therapy.

Aim: Hepatitis C (HC)-related hepatocellular carcinoma (HCC; HC-HCC) is highly recurrent.

Methods: From 1995-2007, 183 curative hepatic resections for primary solitary HC-HCC without postoperative interferon therapy were included in this study. The patients were divided into three groups: (i) 2 cm or less (n = 56); (ii) more than 2 cm to less than 5 cm (n = 79); and (iii) 5 cm or more (n = 48).

A high MELD score, combined with the presence of hepatitis C, is associated with a poor prognosis in living donor liver transplantation.

Purpose: The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed.

Methods: A total of 357 patients who underwent LDLT were included in this analysis.

Results: Overall, 46 patients had high MELD scores (≥ 25) and their graft survival was similar to that in patients with low MELD scores (<25; n = 311; p = 0.

Surgical outcomes of pancreaticoduodenectomy for periampullary tumors in elderly patients.

Backgrounds: Pancreaticoduodenectomy (PD) is an aggressive surgery with considerable operative risks, but offers the only chance for cure in patients with periampullary tumors. A growing number of elderly patients are being offered PD because of the aging of populations in developed countries. We examined surgical outcomes of PD in patients aged 75 years and older (≥75 years).

Strategies for successful left-lobe living donor liver transplantation in 250 consecutive adult cases in a single center.

Background: Living donor liver transplantation (LDLT) using left-lobe grafts was not generally recognized as feasible due to the problem of graft size.

Study Design: We retrospectively evaluated strategies for successful left-lobe LDLT in 250 consecutive cases stratified into 2 eras: Era 1 (n = 121), in which surgical procedures were continually refined, and Era 2 (n = 129), in which established procedures were used.

Results: Graft volume (GV) did not affect the incidence of graft function or survival.

Outcome of hepatectomy in hepatocellular carcinoma patients aged 80 years and older.

Background/aims: The aim of this retrospective study was to determine the effect of age on the outcome of hepatic resection in octogenarian patients with hepatocellular carcinoma (HCC).

Methodology: Data of 408 consecutive primary HCC patients who underwent curative hepatectomy were studied. The surgical results of the younger group (<80 years of age) and the elderly group (≥80 years of age) were compared.

Poor prognostic factors after repeat hepatectomy for recurrent hepatocellular carcinoma in the modern era.

The purpose of this study was to determine the poor prognostic factors after repeat hepatectomy (Hx) in patients with recurrent hepatocellular carcinoma (HCC). Overall survival rates and clinicopathological variables in 112 patients with repeat Hx from 1992 to 2010 were compared with those in 531 patients who underwent a primary Hx. To clarify the poor prognosis factors after repeat Hx, survival data among 112 patients were univariately and multivariately analyzed.

Beneficial effects of preoperative lipiodolization for resectable large hepatocellular carcinoma (≥ 5 cm in diameter).

Background: The effects of preoperative lipiodolization (LPD) for large hepatocellular carcinoma (HCC) are controversial.

Methods: A retrospective review was undertaken for 137 patients with initial solitary resectable HCC ≥ 5 cm who underwent hepatic resection between 1995 and 2008. Forty-two patients underwent preoperative LPD, and clinical data and prognosis were compared to those of patients without preoperative LPD (n=95).

Subcuticular absorbable suture with subcutaneous drainage system prevents incisional SSI after hepatectomy for hepatocellular carcinoma.

Background: The effectiveness of subcuticular absorbable suture with subcutaneous drainage to decrease the risk of postoperative incisional surgical site infection (SSI) in hepatocellular carcinoma (HCC) patients was evaluated.

Methods: A total of 149 patients with HCC who underwent hepatectomy (Hx) were retrospectively investigated. Patients were divided into two groups: the patients with subcuticular suture combined with subcutaneous drainage (the drainage group; 61 patients) and the patients with nylon suture without subcutaneous drainage (the nylon group; 88 patients).

Predictors for microinvasion of small hepatocellular carcinoma ≤ 2 cm.

Background: Hepatocellular carcinoma (HCC) ≤ 2 cm in diameter is considered to have a low potential for malignancy.

Methods: A retrospective review was undertaken of 149 patients with primary solitary HCC ≤ 2 cm who underwent initial hepatic resection between 1994 and 2010. The independent predictors of the microinvasion (MI) such as portal venous, hepatic vein, or bile duct infiltration and/or intrahepatic metastasis were identified by multivariate analysis.

Zero mortality in more than 300 hepatic resections: validity of preoperative volumetric analysis.

Purpose: We reviewed a series of patients who underwent hepatic resection at our institution, to investigate the risk factors for postoperative complications after hepatic resection of liver tumors and for procurement of living donor liver transplantation (LDLT) grafts.

Methods: Between April 2004 and August 2007, we performed 304 hepatic resections for liver tumors or to procure grafts for LDLT. Preoperative volumetric analysis was done using 3-dimensional computed tomography (3D-CT) prior to major hepatic resection.

Outcomes of hepatic resection for huge hepatocellular carcinoma (≥ 10 cm in diameter).

Background: The object of the current study was to review the outcomes of hepatic resection for hepatocellular carcinoma (HCC) ≥ 10 cm.

Methods: Between 1995 and 2007, fifty-three patients with HCC ≥ 10 cm underwent hepatic resection, and clinical data were compared to those of patients with non-surgical treatment (n = 12). Surgical results for HCC ≥ 10 cm were compared to those of patients with HCC < 10 cm (n = 412).

Risk factors for early recurrence after curative hepatectomy for colorectal liver metastases.

Purpose: With the broadening indications for hepatectomy to treat colorectal liver metastases (CRLM), early recurrence is a major problem. The aim of this study is to identify risk factors of early recurrence, defined as recurrence within 1 year after surgery.

Methods: A retrospective analysis was performed on 121 consecutive patients who underwent hepatectomy for CRLM.

Significance of DNA polymerase delta catalytic subunit p125 induced by mutant p53 in the invasive potential of human hepatocellular carcinoma.

Objective: To clarify the role of DNA polymerase delta in tumor progression, we examined the expression of its main catalytic subunit p125 encoded by POLD1 in hepatocellular carcinoma (HCC) and human HCC cell lines.

Methods: We examined the expression of p53 and p125 in HCC by using immunohistochemistry and Western blotting. Characteristic changes observed in human HCC cell lines after transfection were examined.