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No Need of Immediate Treatment for Hypovascular Tumors Associated with Hepatocellular Carcinoma

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Abstract

Background

Hypovascular tumors associated with hepatocellular carcinoma (HCC) can be diagnosed, but it remains unknown whether such lesions should be treated immediately. This study aimed to clarify the clinical significance of treating hypovascular liver nodules.

Methods

After diagnosis of hypovascular tumors smaller than 3 cm, 104 patients underwent liver resection immediately (Group 1), while 93 patients were placed under observation (Group 2). In Group 1, 98 patients were diagnosed as having HCC (Group 1′), while 80 patients in Group 2 underwent liver resection after vascularization or appearance of other hypervascular HCC (Group 2′), eight patients had been observed, and five patients could not undergo operation due to appearance of other multiple HCCs. To avoid lead time bias for tumor vascularization, survival rates of patients after diagnosis of hypovascular tumors as well as those after operation in the two groups were compared.

Results

After a median follow-up of 3.3 years (range 0.6–11.2), the 5-year overall survival rates after liver resection of Group 1′ (74.8 %; 95 % CI 64.3–86.1) was significantly higher than that of Group 2′ (59.2 %; 46.4–75.6; P = 0.027). However, the 5-year overall survival rates after diagnosis of hypovascular liver nodules of Group 1′ (74.7 %; 66.1–85.0) was not significantly different from that of Group 2′ (77.1 %; 67.0–88.6; P = 0.761). Consequently, the 5-year overall survival rate after diagnosis of Group 2 (75.6 %; 64.7–83.1) was not significantly different from that of Group 1 (73.2 %; 67.5–86.1; P = 0.591) by intention-to-treat analysis.

Conclusions

It is not necessary to treat hypovascular liver tumors immediately after diagnosis.

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Acknowledgment

This work was mainly supported by a Grant-in-Aid for Scientific Research (C) 15K10152 (Y.M.) from the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan.

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Authors and Affiliations

  1. Department of Digestive Surgery, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610, Japan

    Yutaka Midorikawa, Tadatoshi Takayama, Kiyoko Ebisawa & Tokio Higaki

  2. Hepato-Biliary-Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, 104-0054, Japan

    Satoshi Nara & Kazuaki Shimada

  3. Division of Hepato-Biliary-Pancreatic Surgery and Transplantation Surgery, Japanese Red Cross Medical Center, Tokyo, 150-8935, Japan

    Takuya Hashimoto & Masatoshi Makuuchi

  4. Department of Surgery, Saitama Cancer Center, Saitama, 362-0806, Japan

    Kiyohiko Omichi & Hirohiko Sakamoto

  5. Genome Science Division, Research Center for Advanced Science and Technologies, University of Tokyo, Tokyo, 153-8904, Japan

    Shingo Tsuji

Authors
  1. Yutaka Midorikawa
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  2. Tadatoshi Takayama
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  3. Satoshi Nara
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  4. Takuya Hashimoto
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  5. Kiyohiko Omichi
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  6. Kiyoko Ebisawa
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  7. Tokio Higaki
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  8. Shingo Tsuji
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  9. Hirohiko Sakamoto
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  10. Kazuaki Shimada
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  11. Masatoshi Makuuchi
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Corresponding author

Correspondence to Tadatoshi Takayama.

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We declare that we have no conflicts of interest.

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This work is not a randomized clinical trial.

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Midorikawa, Y., Takayama, T., Nara, S. et al. No Need of Immediate Treatment for Hypovascular Tumors Associated with Hepatocellular Carcinoma. World J Surg 40, 2460–2465 (2016). https://doi.org/10.1007/s00268-016-3548-4

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  • DOI: https://doi.org/10.1007/s00268-016-3548-4

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