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The tumor diameter cut-off for predicting microscopic intrahepatic metastasis of hepatocellular carcinoma patients without treatment history differs from that of hepatocellular carcinoma patients with a treatment history

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Abstract

Background and aim

Intrahepatic metastasis (IM) of hepatocellular carcinoma (HCC) occurs via vascular invasion; the tumor diameter that affects the risk of micro intra-hepatic metastasis (MIM) should be larger than that which affects the risk of micro vessel invasion (MVI). The aim of the present study was to determine the optimum tumor diameter cut-off value for predicting the presence of MIM in HCC patients without treatment history and HCC patients with a treatment history and to compare these diameters between cases of MVI and MIM.

Methods

This retrospective study included 621 patients without macroscopic vessel invasion or intrahepatic metastasis on preoperative imaging who underwent hepatectomy. The cut-off tumor diameter for predicting the presence of MIM was determined by a receiver operating characteristic curves analysis.

Results

The optimum cut-off value for predicting the presence of MIM in HCC patients without treatment history was 43 mm. In contrast, the optimum cut-off value for predicting the presence of MIM in HCC patients with a treatment history was 20 mm. Among 46 HCC patients with MIM without treatment history, there were 20 patients with MIM without MVI who were considered to have potential multi-centric (MC) tumors rather than IM. The cumulative overall survival rates in patients with MIM without MVI (potential MC) was significantly better than that in patients with both MIM and MVI (P = 0.022).

Conclusions

The tumor diameter cut-off value for predicting MIM differed between HCC patients without treatment history and with a treatment history and slightly smaller than those for predicting MVI beyond our expectation.

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References

  1. Wang MH, Ji Y, Zeng ZC, et al. Impact factors for microinvasion in patients with hepatocellular carcinoma: possible application to the definition of clinical tumor volume. Int J Radiat Oncol Biol Phys. 2010;76:467–76.

    Article  Google Scholar 

  2. Lu XY, Xi T, Lau WY, et al. Pathobiological features of small hepatocellular carcinoma: correlation between tumor size and biological behavior. J Cancer Res Clin Oncol. 2011;137:567–75.

    Article  Google Scholar 

  3. Zhong Y, Deng M, Xu R. Reappraisal of evidence of microscopic portal vein involvement by hepatocellular carcinoma cells with stratification of tumor size. World J Surg. 2015;39:1142–9.

    Article  Google Scholar 

  4. Jonas S, Bechstein WO, Steinmüller T, et al. Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis. Hepatology. 2001;33:1080–6.

    Article  CAS  Google Scholar 

  5. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–9.

    Article  CAS  Google Scholar 

  6. Tsai TJ, Chau GY, Lui WY, et al. Clinical significance of microscopic tumor venous invasion in patients with resectable hepatocellular carcinoma. Surgery. 2000;127:603–8.

    Article  CAS  Google Scholar 

  7. Vauthey JN, Lauwers GY, Esnaola NF, et al. Simplified staging for hepatocellular carcinoma. J Clin Oncol. 2002;20:1527–36.

    Article  Google Scholar 

  8. Liver Cancer Study Group of Japan General rules for the clinical and pathological study of primary liver cancer. 2008. 5th Japanese edition edn. Tokyo: Kanehara

  9. Sobin LH, Gospodarowicz MK, Wittekind CH, editors. TNM Classification of malignant tumours. 7th ed. New York: Wiley-Liss; 2009.

    Google Scholar 

  10. Pawlik TM, Poon RT, Abdalla EK et al (2005) Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg 140:450–457 (discussion 457–458)

    Article  Google Scholar 

  11. Shimada K, Sakamoto Y, Esaki M, et al. Role of a hepatectomy for the treatment of large hepatocellular carcinomas measuring 10 cm or larger in diameter. Langenbecks Arch Surg. 2008;393:521–6.

    Article  Google Scholar 

  12. Ariizumi S, Kotera Y, Takahashi Y, et al. (2013) Impact of hepatectomy for huge solitary hepatocellular carcinoma. J Surg Oncol. 2013;107:408–13.

    Article  Google Scholar 

  13. Lim C, Mise Y, Sakamoto Y, et al. Above 5 cm, size does not matter anymore in patients with hepatocellular carcinoma. World J Surg. 2014;38:2910–8.

    Article  Google Scholar 

  14. Okamura Y, Sugiura T, Ito T, et al (2018) The Predictors of Microscopic Vessel Invasion Differ Between Primary Hepatocellular Carcinoma and Hepatocellular Carcinoma with a Treatment History. World J Surg. 2018. https://doi.org/ https://doi.org/10.1007/s00268-018-4658-y

  15. Nakashima T, Kojiro M. Pathologic characteristics of hepatocellular carcinoma. Semin Liver Dis. 1986;6:259–66.

    Article  CAS  Google Scholar 

  16. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the esophagus for bleeding oesophageal varices. Br J Surg. 1973;60:646–9.

    Article  CAS  Google Scholar 

  17. Okamura Y, Ito T, Sugiura T, et al. Anatomic versus nonanatomic hepatectomy for a solitary hepatocellular carcinoma: a case-controlled study with propensity score matching. J Gastrointest Surg. 2014;18:1994–2002.

    Article  Google Scholar 

  18. Strasberg SM. Nomenclature of hepatic anatomy and resections: a review of the Brisbane 2000 system. J Hepatobiliary Pancreat Surg. 2005;12:351–5.

    Article  Google Scholar 

  19. Wu CC, Cheng SB, Yeh DC, et al. Second and third hepatectomies for recurrent hepatocellular carcinoma are justified. Br J Surg. 2009;96:1049–57.

    Article  Google Scholar 

  20. Yamashita Y, Shirabe K, Tsuijita E, et al. Third or more repeat hepatectomy for recurrent hepatocellular carcinoma. Surgery. 2013;154:1038–45.

    Article  Google Scholar 

  21. Mise Y, Hasegawa K, Shindoh J, et al. The feasibility of third or more repeat hepatectomy for recurrent hepatocellular carcinoma. Ann Surg. 2015;262:347–57.

    Article  Google Scholar 

  22. Kumada T, Nakano S, Takeda IS, et al. Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma. Hepatology. 1997;25:87–92.

    Article  CAS  Google Scholar 

  23. Sugo H, Ishizaki Y, Yoshimoto J, et al. Salvage hepatectomy for local recurrent hepatocellular carcinoma after ablation therapy. Ann Surg Oncol. 2012;19:2238–45.

    Article  Google Scholar 

  24. Takada Y, Kurata M, Ohkohchi N. Rapid and aggressive recurrence accompanied by portal tumor thrombus after radiofrequency ablation for hepatocellular carcinoma. Int J Clin Oncol. 2003;8:332–5.

    Article  Google Scholar 

  25. Nicoli N, Casaril A, Abu Hilal M, et al. A case of rapid intrahepatic dissemination of hepatocellular carcinoma after radiofrequency thermal ablation. Am J Surg. 2004;188:165–7.

    Article  Google Scholar 

  26. Livraghi T, Lazzaroni S, Meloni F, et al. Risk of tumour seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. Br J Surg. 2005;92:856–8.

    Article  CAS  Google Scholar 

  27. Koda M, Maeda Y, Matsunaga Y, et al. Hepatocellular carcinoma with sarcomatous change arising after radiofrequency ablation for well-differentiated hepatocellular carcinoma. Hepatol Res. 2003;27:163–7.

    Article  Google Scholar 

  28. Okamura Y, Ashida R, Ito T, et al. The tumor marker score is an independent predictor of survival in patients with recurrent hepatocellular carcinoma. Surg Today. 2015;45:1513–20.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan

    Y. Okamura, T. Sugiura, T. Ito, Y. Yamamoto, R. Ashida & K. Uesaka

  2. Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital, Shizuoka, Japan

    T. Aramaki

Authors
  1. Y. Okamura
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  2. T. Sugiura
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  3. T. Ito
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  4. Y. Yamamoto
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  5. R. Ashida
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  6. T. Aramaki
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  7. K. Uesaka
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Corresponding author

Correspondence to Y. Okamura.

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Conflict of interest

All authors have no conflict of interest regarding the current study.

Ethical approval

This study confirmed to the ethical guidelines of the Declaration of Helsinki (2013 revision) and was retrospective in nature, and we obtained approval from the Institutional Review Board of Shizuoka Cancer Center for the exception of patient consent (number: 29-J11-29–1-3).

Informed consent

This study was retrospective, and we obtained approval from the Institutional Review Board of Shizuoka Cancer Center for the exception of patients’ consent “29-J11-29-1-3”. This study was conducted in accordance with the ethical standards of the Declaration of Helsinki.

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Okamura, Y., Sugiura, T., Ito, T. et al. The tumor diameter cut-off for predicting microscopic intrahepatic metastasis of hepatocellular carcinoma patients without treatment history differs from that of hepatocellular carcinoma patients with a treatment history. Clin Transl Oncol 22, 319–329 (2020). https://doi.org/10.1007/s12094-019-02120-z

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  • DOI: https://doi.org/10.1007/s12094-019-02120-z

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