Patient selection: hepatic alveolar echinococcosis
Curability was the only independent factor on multivariate analysis associated with overall and progression free survival.
The best outcome was associated with complete resection. If complete resection was not possible, then reduction surgery was performed.
Adjuvant albendazole therapy was given if possible to patients with:
(1) complete resection AND surgical margin < 1 cm: given for 1 year
(2) reduction surgery: given lifelong
Contraindications to albendazole therapy:
(1) age < 15 years OR age > 75 years
(2) pregnancy in females
(3) hepatic dysfunction
(4) development of serious adverse effects during albendazole therapy
Factors associated with disease progression on univariate analysis (other than respectability):
(1) tumor size >= 9 cm
(2) vascular invasion (hepatic vein, portal vein, and/or hepatic artery)
(3) lung metastasis
