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Risk factors for early death after liver resection in patients with solitary hepatocellular carcinoma

  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background/Purpose

Although most patients who receive hepatectomy for a solitary hepatocellular carcinoma (HCC) have a relatively fair result, some have a poor prognosis. The aim of this study was to evaluate the risk factors for early death after hepatectomy in patients with a solitary HCC.

Methods

Eligible patients (n = 110) who had undergone hepatectomy for solitary HCC between 1990 and 2002 and were able to be followed up for more than 2 years after the hepatectomy were divided into two groups, those who died of cancer recurrence within 2 years (early-death group; n = 18) and those who survived for more than 2 years after the surgery (survival group; n = 92). Risk factors for early death after liver resection were evaluated by univariate and multivariate analyses.

Results

The gross tumor classification, tumor diameter, macroscopic portal vein invasion, microscopic growth pattern, microscopic vascular invasion (MVI), and the width of the surgical margin were significant (P < 0.05) factors by univariate analysis. Multivariate analysis showed that the presence of MVI was an independent and significant risk factor for early death of recurrence.

Conclusions

Among patients with solitary HCC, the presence of MVI indicates a poor prognosis. These patients need adjuvant chemotherapy in the early period after hepatectomy.

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References

  1. T Livraghi (2003) ArticleTitleRadiofrequency ablation, PEIT, and TACE for hepatocellular carcinoma J Hepatobiliary Pancreat Surg 10 67–76 Occurrence Handle12918460

    PubMed  Google Scholar 

  2. G Ercolani GL Grazi M Ravaioli MD Gaudio A Gardini M Cescon et al. (2003) ArticleTitleLiver resection for hepatocellular carcinoma on cirrhosis: univariate and multivariate analysis of risk factors for intrahepatic recurrence Ann Surg 237 536–43 Occurrence Handle10.1097/00000658-200304000-00016 Occurrence Handle12677151

    Article  PubMed  Google Scholar 

  3. JM Regimbeau EK Abdalla JN Vauthey GY Lauwers F Durand DM Nagorney et al. (2004) ArticleTitleRisk factors for early death due to recurrence after liver resection for hepatocellular carcinoma: results of a multicenter study J Surg Oncol 58 36–41 Occurrence Handle10.1002/jso.10284

    Article  Google Scholar 

  4. J Yamanaka N Yamanaka K Nakasho T Tanaka T Ando C Yasui et al. (2000) ArticleTitleClinicopathologic analysis of stage II–III hepatocellular carcinoma showing early massive recurrence after liver resection J Gastroenterol Hepatol 15 1192–8 Occurrence Handle10.1046/j.1440-1746.2000.02323.x Occurrence Handle11106101

    Article  PubMed  Google Scholar 

  5. T Sonoyama T Ochiai T Hironaka H Yamagishi (2003) ArticleTitlePredictors of postoperative diffuse intrahepatic recurrence of hepatocellular carcinoma Hepatogastroenterology 50 1078–84 Occurrence Handle12845986

    PubMed  Google Scholar 

  6. InstitutionalAuthorNameLiver Cancer Study Group of Japan (2003) General rules for the clinical and pathological study of primary liver cancer EditionNumber2nd English ed. Kanehara Tokyo

    Google Scholar 

  7. RN Pugh IM Murray-Lyon JL Dawson MC Pietroni R Williams (1973) ArticleTitleTransection of the oesophagus for bleeding oesophageal varices Br J Surg 60 646–9 Occurrence Handle4541913

    PubMed  Google Scholar 

  8. T Kumada S Nakano I Takeda K Sugiyama T Osada S Kiriyama et al. (1997) ArticleTitlePatterns of recurrence after initial treatment in patients with small hepatocellular carcinoma Hepatology 25 87–92 Occurrence Handle8985270

    PubMed  Google Scholar 

  9. RT-P Poon S-T Fan IO-L Ng C-M Lo C-L Liu J Wong (2000) ArticleTitleDifferent risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma Cancer 89 500–7 Occurrence Handle10.1002/1097-0142(20000801)89:3<500::AID-CNCR4>3.0.CO;2-O Occurrence Handle10931448

    Article  PubMed  Google Scholar 

  10. O Nakashima M Kojiro (2001) ArticleTitleRecurrence of hepatocellular carcinoma: multicentric occurrence or intrahepatic metastasis? A viewpoint in terms of pathology J Hepatobiliary Pancreat Surg 8 404–9 Occurrence Handle10.1007/s005340100001 Occurrence Handle11702248

    Article  PubMed  Google Scholar 

  11. M Sakon M Monden K Umeshita M Gotoh T Kanai T Mori et al. (1994) ArticleTitleThe prognostic significance of macroscopic growth pattern of hepatocellular carcinoma Int Surg 79 38–42 Occurrence Handle8063553

    PubMed  Google Scholar 

  12. T Wakai Y Shirai T Nomura S Nagakura K Hatakeyama (2002) ArticleTitleComputed tomographic features of hepatocellular carcinoma predict long-term survival after hepatic resection Eur J Surg Oncol 28 235–42 Occurrence Handle10.1053/ejso.2001.1241 Occurrence Handle11944955

    Article  PubMed  Google Scholar 

  13. M Takata N Yamanaka T Tanaka J Yamanaka S Maeda E Okamoto et al. (2000) ArticleTitleWhat patients can survive disease-free after complete resection for hepatocellular carcinoma? A multivariate analysis Jpn J Clin Oncol 30 75–81 Occurrence Handle10.1093/jjco/hyd016 Occurrence Handle10768870

    Article  PubMed  Google Scholar 

  14. N Nagasue (1998) ArticleTitleLiver resection for hepatocellular carcinoma: indication, techniques, complications, and prognostic factors J Hepatobiliary Pancreat Surg 5 7–13 Occurrence Handle9683747

    PubMed  Google Scholar 

  15. T Asahara K Dohi K Katayama T Itamoto Y Okamoto H Nakahara et al. (1998) ArticleTitleFactors affecting postoperative prognosis in the solitary nodule type of hepatocellular carcinoma: experience of 132 cases in our institute Hiroshima J Med Sci 47 99–104 Occurrence Handle9810780

    PubMed  Google Scholar 

  16. T Ochiai T Takayama K Inoue J Yamamoto K Shimada T Kosuge et al. (1999) ArticleTitleHepatic resection with and without surgical margins for hepatocellular carcinoma in patients with impaired liver function Hepatogastroenterology 46 1885–9 Occurrence Handle10430364

    PubMed  Google Scholar 

  17. N Nagasue T Ono A Yamanoi H Kohno ON El-Assal H Taniura et al. (2001) ArticleTitlePrognostic factors and survival after hepatic resection for hepatocellular carcinoma without cirrhosis Br J Surg 88 515–22 Occurrence Handle10.1046/j.1365-2168.2001.01732.x Occurrence Handle11298618

    Article  PubMed  Google Scholar 

  18. WC Lee LB Jeng MF Chen (2002) ArticleTitleEstimation of prognosis after hepatectomy for hepatocellular carcinoma Br J Surg 89 311–6 Occurrence Handle10.1046/j.0007-1323.2001.02034.x Occurrence Handle11872055

    Article  PubMed  Google Scholar 

  19. T Nakajima M Kojiro (1986) ArticleTitlePathologic characteristics of hepatocellular carcinoma Semin Liver Dis 6 259–66 Occurrence Handle3022387

    PubMed  Google Scholar 

  20. T Nonami K Isshiki H Katoh W Kishimoto A Harada A Nakao et al. (1991) ArticleTitleThe potential role of postoperative hepatic artery chemotherapy in patients with high-risk hepatomas Ann Surg 213 222–6 Occurrence Handle1847795

    PubMed  Google Scholar 

  21. K Takenaka K Yoshida T Nishizaki D Korenaga K Hiroshige T Ikeda et al. (1995) ArticleTitlePostoperative prophylactic lipiodolization reduces the intrahepatic recurrence of hepatocellular carcinoma Am J Surg 169 400–5 Occurrence Handle10.1016/S0002-9610(99)80184-6 Occurrence Handle7694977

    Article  PubMed  Google Scholar 

  22. WY Lau TWT Leung SKW Ho M Chan D Machin J Lau et al. (1999) ArticleTitleAdjuvant intra-arterial iodine-131-labelled lipiodol for resectable hepatocellular carcinoma: a prospective randomized trial Lancet 353 797–801 Occurrence Handle10.1016/S0140-6736(98)06475-7 Occurrence Handle10459961

    Article  PubMed  Google Scholar 

  23. T Takayama T Sekine M Makuuchi S Yamasaki T Kosuge J Yamamoto et al. (2000) ArticleTitleAdoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomized trial Lancet 356 802–7 Occurrence Handle10.1016/S0140-6736(00)02654-4 Occurrence Handle11022927

    Article  PubMed  Google Scholar 

  24. S Bhattacharjya T Bhattacharjya A Quaglia AP Dhillon AK Burroughs DW Patch et al. (2004) ArticleTitleLiver transplantation in cirrhotic patients with small hepatocellular carcinoma: an analysis of pre-operative imaging, explant histology and prognostic histologic indicators Dig Surg 21 152–9 Occurrence Handle10.1159/000078741 Occurrence Handle15166485

    Article  PubMed  Google Scholar 

  25. K Shirabe T Kanematsu T Matsumata E Adachi K Akazawa K Sugimachi (1991) ArticleTitleFactors linked to early recurrence of small hepatocellular carcinoma after hepatectomy: univariate and multivariate analyses Hepatology 14 802–5 Occurrence Handle1657754

    PubMed  Google Scholar 

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Authors and Affiliations

  1. First Department of Surgery, Faculty of Medicine, Miyazaki University, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Kazuhiro Kondo, Kazuo Chijiiwa, Ichiro Makino, Masahiro Kai, Naoki Maehara, Jiro Ohuchida & Seiji Naganuma

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  1. Kazuhiro Kondo
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  2. Kazuo Chijiiwa
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  3. Ichiro Makino
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  4. Masahiro Kai
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  5. Naoki Maehara
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  6. Jiro Ohuchida
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  7. Seiji Naganuma
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Kondo, K., Chijiiwa, K., Makino, I. et al. Risk factors for early death after liver resection in patients with solitary hepatocellular carcinoma. J Hepatobiliary Pancreat Surg 12, 399–404 (2005). https://doi.org/10.1007/s00534-005-1009-9

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  • DOI: https://doi.org/10.1007/s00534-005-1009-9

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