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Prognostic Factors and Recurrence of Small Hepatocellular Carcinoma after Hepatic Resection or Microwave Ablation: A Retrospective Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Purpose

This study aims to analyze the long-term therapeutic results of small HCC less than 5 cm in diameter after microwave ablation (MA) or hepatic resection (HR) and choose factors that could predict metastasis and recurrence of small HCC.

Materials and Methods

The metastasis and recurrence of 194 patients with one HCC less than 5 cm in diameter who underwent curative HR or MA between January 1995 and December 2004 were reviewed retrospectively; immunohistochemistry was used to analyze the expressions of VEGF, bFGF, and c-Met in HCC tissues. Posttreatment prognostic factors were evaluated by multivariate analysis using Cox’s proportional hazards model. The variables included the expressions of these three proteins in HCC tissues, the clinical and pathologic characteristics of the patients.

Results

The retrospective study showed that 1-, 3-, and 5-year disease-free survival rates of patients with single HCC of diameter <5 cm were 71.3, 57.0 and 32.5%, respectively. Furthermore, 1-, 3-, and 5-year disease-free survival rates of the patients in MA group and resection group were 72.8, 54.0 and 33.0%; 68.5, 60.0, and 25.6%, respectively. There was no significant difference in disease-free survival rates between these two groups. The result of multivariate analysis showed that differentiation degree of HCC and the expressions of VEGF and c-Met in HCC tissues could be as the independent prognostic factors affecting metastasis and recurrence in patients with small HCC, whereas the methods of therapy had no impact on prognosis.

Conclusions

The metastasis and recurrence rate after MA is similar to that after HR, and the methods of therapy do not affect the prognosis of small HCC. The metastasis and recurrence of patients with small HCC will differ depending on tumor differentiation, expressions of VEGF and c-Met in HCC tissues.

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References

  1. Nagashima I, Hamada C, Naruse K, Osada T, Nagao T, Muto T. Surgical resection for small hepatocellular carcinoma. Surgery 1996;119:40–45.

    Article  PubMed  CAS  Google Scholar 

  2. Makuuchi M, Kosuge T, Takayama T, Yamazaki S, Kakazu T, Miyagawa S, Kawasaki S. Surgery for small liver cancers. Semin Surg Oncol 1993;9:298–304.

    Article  PubMed  CAS  Google Scholar 

  3. Yamasaki S, Hasegawa H, Makuuchi M, Takayama T, Kosuge T, Shimada K. Choice of treatment for small hepatocellular carcinoma: hepatectomy, embolization or ethanol injection. J Gastroenterol Hepatol 1991;6:408–413.

    PubMed  CAS  Google Scholar 

  4. Dong BW, Liang P, Yu XL, Zeng XQ, Wang PJ, Su L, Wang XD, Xin H, Li S. Sonographically guided microwave coagulation treatment of liver cancer: an experimental and clinical study. AJR 1998;171:449–454.

    PubMed  CAS  Google Scholar 

  5. Muto Y, Moriwaki H, Ninomiya M, Adachi S, Saito A, Takasaki KT, Tanaka T, Tsurumi K, Okuno M, Tomita E, Nakamura T, Kojima T. Prevention of second primary tumors by an acyclic retinoid, polyprenoic acid, in patients with hepatocellular carcinoma. N Engl J Med 1996;334:1561–1567.

    Article  PubMed  CAS  Google Scholar 

  6. Takayama T, Sekine T, Makuuchi M, Yamasaki S, Kosuge T, Yamamoto J, Shimada K, Sakamoto M, Hirohashi S, Ohashi Y, Kakizoe T. Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomized trial. Lancet 2000;356:802–807.

    Article  PubMed  CAS  Google Scholar 

  7. Chen YJ, Ye SH, Chen JT, Wu CC, Hsu MT, Tsai SF, Chen PJ, Lin CH. Chromosomal changes and clonality relationship between primary and recurrent hepatocellular carcinoma. Gastroenterology 2000;119:431–440.

    Article  PubMed  CAS  Google Scholar 

  8. Okada S, Shimada K, Yamamoto J, Takayama T, Kosuge T, Yamasaki S, Sakamoto M, Hirohashi S. Predictive factors for postoperative recurrence of hepatocellular carcinoma. Gastroenterology 1994;106:1618–1624.

    PubMed  CAS  Google Scholar 

  9. Llovet JM, Fuster J, Bruix J. Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 1999;30:1434–1440.

    Article  PubMed  CAS  Google Scholar 

  10. Mattern J, Koomagi R, Volm M. Coexpression of VEGF and bFGF in human epidermoid lung carcinoma is associated with increased vessel density. Anticancer Res 1997;17:2249–2252.

    PubMed  CAS  Google Scholar 

  11. Volm M, Koomagi R, Mattern J. Prognostic value of vascular endothelial growth factor and its receptor Flt-1 in squamous cell lung cancer. Int J Cancer 1997;74:64–68.

    Article  PubMed  CAS  Google Scholar 

  12. Compagni A, Wilgenbus P, Impagnatiello MA, Cotten M, Christofori G. Fibroblast growth factors are required for efficient tumor angiogenesis. Cancer Res 2000;60:7163–7169.

    PubMed  CAS  Google Scholar 

  13. Qin LX, Tang ZY. The prognostic molecular markers in hepatocellular carcinoma. World J Gastroenterol 2002;8:385–392.

    PubMed  CAS  Google Scholar 

  14. Horiguchi N, Takayama H, Toyoda M, Otsuka T, Fukusato T, Merlino G, Takaqi H, Mori M. Hepatocyte growth factor promotes hepatocarcinogenesis through c-Met autocrine activation and enhanced angiogenesis in transgenic mice treated with diethylnitrosamine. Oncogene 2002;21:1791–1799.

    Article  PubMed  CAS  Google Scholar 

  15. Okada S. Local ablation therapy for hepatocellular carcinoma. Semin Liver Dis 1999;19:323–328.

    Article  PubMed  CAS  Google Scholar 

  16. Poon RT, Fan ST, Lo CM, Liu CL, Wong J. Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg 1999;229:216–222.

    Article  PubMed  CAS  Google Scholar 

  17. Shimoyawa N, Hanayaki K. Long-term prognosis after hepatic resection for small hepatocellular carcinoma. J Am Coll Surg 2004;198:356–365.

    Article  Google Scholar 

  18. Tung-Ping Poon R, Fan ST, Wong J. Risk factors, prevention and management of postoperative recurrence after resection of hepatocellular carcinoma. Ann Surg 2000;232:10–24.

    Article  PubMed  CAS  Google Scholar 

  19. Mise M, Arii S, Higashituji H, Furutani M, Niwano M, Harada T, Ishigami S, Toda Y, Nakayama H, Fukumoto M, Fujita J, Imamura M. Clinical significance of vascular endothelial growth factor and basic fibroblast growth factor gene expression in liver tumor. Hepatology 1996;23:455–464.

    Article  PubMed  CAS  Google Scholar 

  20. Maulik G, Shrikhande A, Kijima T, Ma PC, Morrison PT, Salgia R. Role of the hepatocyte growth factors receptor, c-Met, in oncogenesis and potential for therapeutic inhibition. Cytokine Growth Factor Rev 2002;13:41–59.

    Article  PubMed  CAS  Google Scholar 

  21. Saftoiu A, Ciurea T, Banita M, Georgescu C, Comanescu V, Rogoveanu I, Gorunescu F, Georfescu I. Immunohistochemical assessment of angiogenesis in primary hepatocellular carcinoma. Rom J Gastroenterol 2004;13:3–8.

    PubMed  Google Scholar 

  22. Chow NH, Cheng KS, Lin PW, Chan SH, Su WC, Sun YN, Lin XZ. Expression of fibroblast growth factor-1 and fibroblast growth factor-2 in normal liver and hepatocellular carcinoma. Dig Dis Sci 1998;43:2261–2266.

    Article  PubMed  CAS  Google Scholar 

  23. Okano J, Shiota G, Kawasaki H. Expression of hepatocyte growth factor (HGF) and HGF receptor (c-met) proteins in liver disease: and immunohistochemical study. Liver 1999;19:151–159.

    Article  PubMed  CAS  Google Scholar 

  24. Okada S. Local ablation therapy for hepatocellular carcinoma. Semin Liver Dis 1999;19:323–328.

    PubMed  CAS  Google Scholar 

  25. Botha JF, Langnas AN. Liver transplantation for hepatocellular carcinoma: an update. J Natl Compr Canc Netw 2006;4:762–767.

    PubMed  Google Scholar 

  26. Liang P, Dong B, Yu X, Yu D, Wang Y, Feng L, Xiao Q. Prognostic factors for survival in patients with hepatocellular carcinoma after percutaneous microwave ablation. Radiology 2005;235:299–307.

    Article  PubMed  Google Scholar 

  27. Seki T, Wakabayashi M, Nakagawa T, Itho T, Shiro T, Kunieda K, Sato M, Uchiyama S, Inoue K. Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer 1994;74:817–825.

    Article  PubMed  CAS  Google Scholar 

  28. Midorikawa T, Kumada K, Kikuchi H, Ishibashi K, Yagi H, Nagasaki H, Nemoto H, Saitoh M, Nakano H, Yamaguchi M, Koh Y, Sakai H, Yoshiyawa Y, Sanada Y, Yoshiba M. Microwave coagulation therapy for hepatocellular carcinoma. J Hepatobiliary Pancreat Surg 2000;7:252–259.

    Article  PubMed  CAS  Google Scholar 

  29. Asahara T, Nakahara H, Fukuda T, Nakatani T, Yano M, Hino H, Okamoto Y, Katayama K, Itamoto T, Ono E, Dohi K, Kitamoto M, Nakanishi T. Percutaneous microwave coagulation therapy for hepatocellular carcinoma. Hiroshima J Med Sci 1998;47:151–155.

    PubMed  CAS  Google Scholar 

  30. Shimada S, Hirota M, Beppu T, Matsuda T, Hayashi N, Tashima S, Takai E, Yamaguchi K, Inoue K, Ogawa M. Complications and management of microwave coagulation therapy for primary and metastatic liver tumors. Surg Today 1998;28:1130–1137.

    Article  PubMed  CAS  Google Scholar 

  31. Solbiati L, Tonolini M, Cova L. Monitoring RF ablation. Eur Radiol 2004;14(suppl 8):34–42.

    Google Scholar 

  32. Nakashima Y, Nakashima O, Tanaka M, Okuda K, Nakashima M, Kojiro M. Portal vein invasion and intrahepatic micrometastasis in small hepatocellular carcinoma by gross type. Hepatol Res 2003;26:142–147.

    Article  PubMed  Google Scholar 

  33. Yoshiji H, Kuriyama S, Yoshii J, Yamazaki M, Kikukawa M, Tsujinoue H, Nakatani T, Fukui H. Vascular endothelial growth factor tightly regulates in vivo development of murine hepatocellular carcinoma cells. Hepatology 1998;28:1489–1496.

    Article  PubMed  CAS  Google Scholar 

  34. Ueki T, Fujimoto J, Suzuki T, Yamamoto H, Okamoto E. Expression of hepatocyte growth factor and its receptor c-met proto-oncogene in hepatocellular carcinoma. Hepatology 1997;25:862–866.

    Article  PubMed  CAS  Google Scholar 

  35. Poon RT, Ng IOL, Lau C, Yu WC, Fan ST, Wong J. Correlation of serum basic fibroblast growth factor levels with clinicopathologic features and postoperative recurrence in hepatocellular carcinoma. Am Surg 2001;182:298–304.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Ultrasound, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, People’s Republic of China

    Zhi Li Wang, Ping Liang, Bao Wei Dong, Xiao Ling Yu & De Jiang Yu

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  1. Zhi Li Wang
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  2. Ping Liang
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Correspondence to Ping Liang.

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Wang, Z.L., Liang, P., Dong, B.W. et al. Prognostic Factors and Recurrence of Small Hepatocellular Carcinoma after Hepatic Resection or Microwave Ablation: A Retrospective Study. J Gastrointest Surg 12, 327–337 (2008). https://doi.org/10.1007/s11605-007-0310-0

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  • DOI: https://doi.org/10.1007/s11605-007-0310-0

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