The clinical significance of lymph node metastases in patients undergoing surgery for hepatocellular carcinoma
- 136 Downloads
The frequency of lymph node (LN) metastasis in patients undergoing surgery for hepatocellular carcinoma (HCC) has rarely been studied. We evaluated the clinicopathologic characteristics and outcomes of six patients with nodal metastases from HCC among a total of 504 patients who underwent hepatic resection for HCC in our department over a 16-year period. The nodal metastases were diagnosed preoperatively in two patients. The average diameter of the resected tumors was 7.8 cm and all were confirmed as poorly differentiated HCC. All of the six patients had intrahepatic metastatic nodules and five also had portal vein invasion. One patient underwent limited resection, and the other five underwent bisegmentectomy. All of the regional LNs were removed in one patient, while only enlarged LNs were removed in the other five. One patient died of postoperative liver failure and the others all died later of intrahepatic or nodal recurrence. Our findings suggest that the prognosis of patients with nodal metastasis from HCC is generally poor, even if hepatic resection with regional LN dissection is performed.
Key wordsHepatocellular carcinoma Lymph node metastasis Hepatic resection
Unable to display preview. Download preview PDF.
- 1.Yoshioka M, Yamamoto M, Fujii H, Matsumoto Y, Sugahara K (1981) Characteristics of lymph node metastases of hepatocellular carcinoma comparing to cholangiocellular carcinoma — a statistical analysis of annual pathological autopsy cases in Japan from 1972 to 1981 (in Japanese with English abstract). Acta Hepatol Jpn 26:1034–1039Google Scholar
- 4.4. The Liver Cancer Study Group of Japan (1990) Primary liver cancer of Japan: clinicopathological features and results of surgical treatment. Ann Surg 211:277–287Google Scholar
- 5.Morita S, Gotoh H, Nagano H, Sakon M, Kanai T, Umeshita K, Wakasa K, Sakurai M, Nakamura H, Kuroda C, Monden M, Mori T (1993) Two surgical cases of hepatocellular carcinoma with lymph node metastasis (in Japanese with English abstract). Jpn J Gastroenterol Surg 26:2449–2453Google Scholar
- 6.Wakabayashi H, Miyauchi A, Kokudo Y, Hamamoto I, Tsubouchi T, Okada S, Maeba T, Maeta H (1995) A clinicopathological evaluation of 5 operated cases of hepatocellular carcinoma which involved lymph node metastasis (in Japanese with English abstract). J Jpn Surg Assoc 56:789–793Google Scholar
- 7.Yamashita Y, Kurohiji T, Kimituki H, Hiraki M, Hayashi J, Watanabe J, Sakamoto K, Kakegawa T (1991) Three cases of hepatocellular carcinoma with lymph node metastasis (in Japanese). Kan Tan Sui 22:963–966Google Scholar
- 11.Magari S, Fujikawa K, Nishi A (1981) Form, distribution, fine structure and function of hepatic lymphatics with special reference to blood vessels and bile ducts. Asian Med J 24:254–270Google Scholar
- 13.Miyoshi Y, Imaoka S, Sasaki Y, Shibata T, Ishikawa O, Oohigashi H, Iwanaga T, Kuroiwa S, Wada H (1988) Investigation of lymph node metastases in autopsied cases of hepatocellular carcinoma: comparison between with and without liver cirrhosis (in Japanese with English abstract). Acta Hepatol Jpn 53:341–346Google Scholar