Abstract
This report is based on an analysis of the recurrent patterns and post-treatment clinical outcome of 78 patients following hepatectomy for hepatocellular carcinoma (HCC). Patients with a single recurrent tumor (group A;n=41) often had multicentric carcinogenesis (41.7%) and were treated locally; i.e., by re-resection or by percutaneous ethanol injection therapy (PEIT). Many of them (42.9%) followed the “curative pattern,” with good prognosis (70.3% 5-year survival rate). Although 6 of the patients with two or three recurrent tumors (group B;n=19) had multicentric carcinogenesis that could be treated locally, 13 of the 19 followed the “non-curative pattern,” with a poor prognosis after recurrence (14.8% 3-year survival rate after recurrence). The primary tumors of the patients with multiple or infiltrating type (group C;n=18) were advanced and these patients had metastatic recurrence, thereby following the “early death pattern” (58.8%) with a poor prognosis (30% 5-year survival rate). For group C patients, hepatectomy was regarded as part of a multidisciplinary treatment regimen that included aggressive postoperative chemotherapy as a necessary component.
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References
Okuda K (1986) Early recognition of hepatocellular carcinoma. Hepatology 6:729–738
Makuuchi M, Hasegawa H, Yamazaki S, Takayasu K, Moriyama N (1987) The use of operative ultrasound as an aid to liver resection in patients with hepatocellular carcinoma. World J Surg 11:615–621
The Liver Cancer Study Group of Japan (1990) Primary liver cancer in Japan: Clinicopathologic features and results of surgical treatment. Ann Surg 211:277–287
Takayasu K, Muramatsu Y, Moriyama N, Hasegawa H, Makuuchi M, Okazaki N, Hirohashi S, Tsugane S (1989) Clinical and radiologic assessments of the results of hepatectomy for small hepatocellular carcinoma and therapeutic arterial embolization for postoperative recurrence Cancer 64:1848–1852
Ohto M, Sugiura N, Ebara M, Kimura K (1985) Usefulness of ultrasound in treatment of hepatocellular carcinoma (in Japanese with English abstract). Jpn J Med Ultrasonics 47:13–14
Tsuda H, Hirohashi S, Shimosato Y, Terada M, Hasegawa H (1988) Clonal origin of atypical adenomatous hyperplasis of the liver and clonal identity with hepatocellular carcinoma. Gastroenterology 95:1664–1666
Takayama T, Makuuchi M, Hirohashi S, Sakamoto M, Okazaki N, Takayasu K, Kosuge T, Motoo Y, Yamazaki S, Hasegawa H (1990) Malignant transformation of adenomatous hyperplasia to hepatocellular carcinoma. Lancet 336:1150–1153
Okuda K, Tanaka M, Nakayama T, Saitsu H, Tanikawa K, Nakashima O, Kojiro M (1993) Clinicopathologic comparison between resected hepatocellular carcinomas (HCC) and recurrent tumors: A special reference to multicentric carcinogenesis of HCC. Int Hepatol Commun 1:65–71
Kobayashi K, Sugimoto T, Makino H, Kumagai M, Unoura M, Tanaka N, Kato Y, Hattori N (1985) Screening methods for early detection of hepatocellular carcinoma. Hepatology 5:1100–1105
Liver Cancer Study Group of Japan (1992) The general rules for the clinical and pathological study of primary liver cancer (in Japanese). Kanehara, Tokyo
Majima Y, Fujimoto T, Iwai I, Tanaka M, Sakai T, Abe M, Abe H, Tanikawa K (1987) Histological diagnosis of hepatocellular carcinoma by a new technique of ultrasound-guided fine needle biopsy (in Japanese with English abstract). Acta Hepatol Jpn 29:628–636
Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S (1983) Hepatic artery embolization in 120 patients with unresectale hepatoma. Radiology 148:397–401
Buchwald H, Grage TB, Vassilopoulos PP, Rohde TD, Varco RL, Blackshear PJ (1980) Intra-arterial infusion chemotherapy for hepatic carcinoma using a totally implantable infusion pump. Cancer 45:866–869
Kanai T, Hirohashi S, Upton MP, Noguchi M, Kishi K, Makuuchi M, Yamasaki S, Hasegawa H, Takayasu K, Moriyama N, Shimosato Y (1987) Pathology of small hepatocellular carcinoma: A proposal for a new gross classification. Cancer 60:810–819
Matsumata T, Kanematsu T Takenaka K, Yoshida Y, Nishizaki T, Sugimachi K (1989) Patterns of intrahepatic recurrence after curative resection of hepatocellular carcinoma. Hepatology 9:457–460
Takayasu K, Wakao F, Moriyama N, Muramatsu Y, Yamazaki S, Kosuge T, Okada S, Okazaki N, Makuuchi M (1992) Postresection recurrence of hepatocellular carcinoma treated by arterial embolization: Analysis of prognostic factors. Hepatology 16:906–911
Sugihara S, Kojiro M, Nakashima T, Saitsu H, Nakayama T (1986) Pathomorphological study on hepatocellular carcinoma: A study of the developmental process of hepatocellular carcinoma in resected cases (in Japanese with English abstract). Acta Hepatol Jpn 27:607–614
Sugihara S, Nakashima O, Kojiro M, Majima Y, Tanaka M, Tanikawa K (1992) The morphologic transition in hepatocellular carcinoma: A comparison of the individual histologic features disclosed by ultrasound-guided fine-needle biopsy with those of autopsy. Cancer 70:1488–1492
Saistu H, Muta M, Ogami Y, Matsumoto A, Sigetomi K, Andou K, Taniwaki S, Sugiyama T, Okuda K, Nakayama T, Ooishi K (1992) A study of resected hepatocellular carcinoma in terms of Kobayashi's risk score (in Japanese with English abstract). J Jpn Pract Surg Soc 53:63–68
Karpas CM, Payson BA, Rechtschaffen J (1971) Intestinal metaplasia and multicentric carcinoma of stomach. N Y State J Med 71:1190–1195
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Taniwaki, S., Okuda, K., Saitsu, H. et al. Recurrent patterns and prognosis following resection of hepatocellular carcinoma. J Hep Bil Pancr Surg 2, 156–162 (1995). https://doi.org/10.1007/BF02348742
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DOI: https://doi.org/10.1007/BF02348742