More refined evaluation of the liver function reserve isoften needed, as a result of limitations in the discriminatory ability of the CPT system, as it uses subjective parameters, such as ascites and encephalopathy. 5 – 7 CPT class A patients are generally considered good candidates for hepatic resection and good post-operative outcome is expected. 5 CPT class C is considered an absolute contraindication for surgical treatment, whereas only few hepatectomies are performed in class B cirrhosis. 3, 4 Therefore, a thorough evaluation of the hepatic function reserve is necessary prior to surgical intervention, in order to select the best candidates for hepatic resection among cirrhotic patients, with reasonable post-operative morbidity and mortality.Ĭhild–Pugh–Turcotte (CPT) classification was the first systematic approach used to determine the severity of cirrhosis and select those patients who could tolerate hepatic resection. The risk of hepatic failure in a cirrhotic patient undergoing hepatectomy still remains high, as a result of compromised function of the liver remnant. 2Įvolution in surgical techniques and peri-operative care have improved post-operative outcome, in patients with severe underlying liver disease undergoing hepatectomy. 1 The mainstay of treatment, in patients with solitary HCC and good liver function, is hepatic resection. Its incidence is 1:500 000 and it is strongly correlated with cirrhosis. Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide.
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