Effect of the pringle maneuver on tumor recurrence of hepatocellular carcinoma after curative resection (EPTRH): a randomized, prospective, controlled multicenter trial

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• 作者：Feng Xiaobin (1)
  Zheng Shuguo (1)
  Zhou Jian (3)
  Qiu Yudong (4)
  Liang Lijian (5)
  Ma Kuansheng (1)
  Li Xiaowu (1)
  Xia Feng (1)
  Yi Dong (6)
  Wang Shuguang (1)
  Bie Ping (1)
  Dong Jiahong (2)
  
• 关键词：Hepatocellular carcinoma ; Ischemia/reperfusion ; Hepatectomy ; Pringle maneuver
• 刊名：BMC Cancer
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：12
• 期：1
• 全文大小：204KB
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  51. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/12/340/prepub
  
• 作者单位：Feng Xiaobin (1)
  Zheng Shuguo (1)
  Zhou Jian (3)
  Qiu Yudong (4)
  Liang Lijian (5)
  Ma Kuansheng (1)
  Li Xiaowu (1)
  Xia Feng (1)
  Yi Dong (6)
  Wang Shuguang (1)
  Bie Ping (1)
  Dong Jiahong (2)
  
  1. Institute of hepatobiliary surgery, Southwest Hospital, Third Military Medical University, Chongqing, P. R. China
  3. Institute of liver cancer, Zhongshan Hospital of Fudan University, Shanghai, P. R. China
  4. Department of hepatobiliary surgery, Nanjing Drum Tower Hospital, Nanjing, P. R. China
  5. Department of hepatobiliary surgery, the First Affiliated Hospital, Sun Yet-Sen University, Guangzhou, P. R. China
  6. Department of health statistics, Third Military Medical University, Chongqing, 400038, P. R. China
  2. Institute of hepatobiliary surgery, Chinese PLA General Hospital, Beijing, P. R. China
  
• ISSN：1471-2407

文摘

Background Hepatic resection is currently still the best choice of therapeutic strategies for liver cancer, but the long-term survival rate after surgery is unsatisfactory. Most patients develop intra- and/or extrahepatic recurrence. The reasons for this high recurrence rate are not entirely clear. Recent studies have indicated that ischemia-reperfusion injury to the liver may be a significant factor promoting tumor recurrence and metastasis in animal models. If this is also true in humans, the effects of the Pringle maneuver, which has been widely used in hepatectomy for the past century, should be examined. To date, there are no reported data or randomized controlled studies examining the relationship between use of the Pringle maneuver and local tumor recurrence. We hypothesize that the long-term prognosis of patients with liver cancer could be worsened by use of the Pringle maneuver due to an increase in the rate of tumor recurrence in the liver remnant. We designed a multicenter, prospective, randomized surgical trial to test this hypothesis. Methods At least 498 eligible patients from five participating centers will be enrolled and randomized into either the Pringle group or the non-Pringle group in a ratio of 1:1 using a permuted-blocks randomization protocol. After the completion of surgical intervention, patients will be included in a 3-year follow-up program. Discussion This multicenter surgical trial will examine whether the Pringle maneuver has a negative effect on the long-term outcome of hepatocellular carcinoma patients. The trial will also provide information about prognostic differences, safety, advantages and disadvantages between Pringle and non-Pringle surgical procedures. Ultimately, the results will increase the available information about the effects of ischemia-reperfusion injury on tumor recurrence, which will be of immense benefit to general surgery. Trial registration http://www.clinicaltrials.gov NCT00725335