Long-Term Outcome After Resection of Huge Hepatocellular Carcinoma ≥10 cm: Single-Institution Experience with 471 Patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-07-01

AUTHORS

Shin Hwang, Young-Joo Lee, Ki-Hun Kim, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Sung-Gyu Lee

ABSTRACT

BackgroundTumor recurrence is very common after resection of huge hepatocellular carcinoma (HCC). This study intended to evaluate early recurrence and long-term outcomes in patients with huge HCC ≥ 10 cm after primary resection and treatment of recurrence.MethodsRecurrence and survival outcomes were retrospectively evaluated in 471 patients with huge HCCs who underwent resection between January 2000 and April 2012.ResultsMean tumor diameter was 13.6 ± 3.1 cm, with 93 % of patients having single tumors. Anatomic and R0 resection rates were 91.1 and 89.4 %, respectively. Perioperative mortality rate was 1.7 %. Tumor recurrence and patient survival rates were 62.2 and 69.2 % at 1 year and 76.0 and 35.5 % at 5 years, respectively. Of patients with recurrence, 92.5 % received specific treatment. Median patient survival period after initial intrahepatic recurrence was 16 months. Tumor volume did not affect recurrence or survival outcomes. Independent risk factors for tumor recurrence and patient survival were serum alpha-fetoprotein ≥100 ng/mL, hypermetabolic uptake on positron emission tomography, satellite nodules, and microvascular invasion. These four factors were used to develop a risk prediction model, in which 1-year HCC recurrence rates in patients with 0, 1, 2, 3, and 4 risk factors were 18.7, 30.3, 58.7, 79.0, and 92.1 %, respectively, and their 1-year patient survival rates were 100, 97.0, 75.5, 63.9, and 42.1 %, respectively.ConclusionsIn patients with huge HCCs, hepatic resection with active recurrence treatment resulted in improved long-term survival. Our 4-factor risk prediction model appears to contribute to quantitative postoperative risk estimation for early HCC recurrence and patient survival in patients with HCC ≥ 10 cm. More... »

PAGES

2519-2528

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-015-3129-y

DOI

http://dx.doi.org/10.1007/s00268-015-3129-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1034165245

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26126423


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    "description": "BackgroundTumor recurrence is very common after resection of huge hepatocellular carcinoma (HCC). This study intended to evaluate early recurrence and long-term outcomes in patients with huge HCC\u00a0\u2265\u00a010\u00a0cm after primary resection and treatment of recurrence.MethodsRecurrence and survival outcomes were retrospectively evaluated in 471 patients with huge HCCs who underwent resection between January 2000 and April 2012.ResultsMean tumor diameter was 13.6\u00a0\u00b1\u00a03.1\u00a0cm, with 93\u00a0% of patients having single tumors. Anatomic and R0 resection rates were 91.1 and 89.4\u00a0%, respectively. Perioperative mortality rate was 1.7\u00a0%. Tumor recurrence and patient survival rates were 62.2 and 69.2\u00a0% at 1\u00a0year and 76.0 and 35.5\u00a0% at 5\u00a0years, respectively. Of patients with recurrence, 92.5\u00a0% received specific treatment. Median patient survival period after initial intrahepatic recurrence was 16\u00a0months. Tumor volume did not affect recurrence or survival outcomes. Independent risk factors for tumor recurrence and patient survival were serum alpha-fetoprotein \u2265100\u00a0ng/mL, hypermetabolic uptake on positron emission tomography, satellite nodules, and microvascular invasion. These four factors were used to develop a risk prediction model, in which 1-year HCC recurrence rates in patients with 0, 1, 2, 3, and 4 risk factors were 18.7, 30.3, 58.7, 79.0, and 92.1\u00a0%, respectively, and their 1-year patient survival rates were 100, 97.0, 75.5, 63.9, and 42.1\u00a0%, respectively.ConclusionsIn patients with huge HCCs, hepatic resection with active recurrence treatment resulted in improved long-term survival. Our 4-factor risk prediction model appears to contribute to quantitative postoperative risk estimation for early HCC recurrence and patient survival in patients with HCC\u00a0\u2265\u00a010\u00a0cm.", 
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34 schema:description BackgroundTumor recurrence is very common after resection of huge hepatocellular carcinoma (HCC). This study intended to evaluate early recurrence and long-term outcomes in patients with huge HCC ≥ 10 cm after primary resection and treatment of recurrence.MethodsRecurrence and survival outcomes were retrospectively evaluated in 471 patients with huge HCCs who underwent resection between January 2000 and April 2012.ResultsMean tumor diameter was 13.6 ± 3.1 cm, with 93 % of patients having single tumors. Anatomic and R0 resection rates were 91.1 and 89.4 %, respectively. Perioperative mortality rate was 1.7 %. Tumor recurrence and patient survival rates were 62.2 and 69.2 % at 1 year and 76.0 and 35.5 % at 5 years, respectively. Of patients with recurrence, 92.5 % received specific treatment. Median patient survival period after initial intrahepatic recurrence was 16 months. Tumor volume did not affect recurrence or survival outcomes. Independent risk factors for tumor recurrence and patient survival were serum alpha-fetoprotein ≥100 ng/mL, hypermetabolic uptake on positron emission tomography, satellite nodules, and microvascular invasion. These four factors were used to develop a risk prediction model, in which 1-year HCC recurrence rates in patients with 0, 1, 2, 3, and 4 risk factors were 18.7, 30.3, 58.7, 79.0, and 92.1 %, respectively, and their 1-year patient survival rates were 100, 97.0, 75.5, 63.9, and 42.1 %, respectively.ConclusionsIn patients with huge HCCs, hepatic resection with active recurrence treatment resulted in improved long-term survival. Our 4-factor risk prediction model appears to contribute to quantitative postoperative risk estimation for early HCC recurrence and patient survival in patients with HCC ≥ 10 cm.
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41 schema:keywords BackgroundTumor recurrence
42 ConclusionsIn patients
43 HCC recurrence
44 HCC recurrence rate
45 Median patient survival period
46 MethodsRecurrence
47 R0 resection rate
48 active recurrence treatment
49 alpha-fetoprotein
50 carcinoma
51 diameter
52 early HCC recurrence
53 early recurrence
54 emission tomography
55 estimation
56 experience
57 factors
58 hepatic resection
59 hepatocellular carcinoma
60 huge HCC
61 huge hepatocellular carcinoma
62 hypermetabolic uptake
63 improved long-term survival
64 independent risk factor
65 initial intrahepatic recurrence
66 intrahepatic recurrence
67 invasion
68 long-term outcomes
69 long-term survival
70 microvascular invasion
71 model
72 months
73 mortality rate
74 nodules
75 outcomes
76 patient survival
77 patient survival period
78 patient survival rates
79 patients
80 period
81 perioperative mortality rate
82 positron emission tomography
83 postoperative risk estimation
84 prediction model
85 primary resection
86 quantitative postoperative risk estimation
87 rate
88 recurrence
89 recurrence rate
90 recurrence treatment
91 resection
92 resection rate
93 risk estimation
94 risk factors
95 risk prediction model
96 satellite nodules
97 serum alpha-fetoprotein
98 single tumor
99 single-institution experience
100 specific treatment
101 study
102 survival
103 survival outcomes
104 survival period
105 survival rate
106 term outcome
107 tomography
108 treatment
109 treatment of recurrence
110 tumor diameter
111 tumor recurrence
112 tumor volume
113 tumors
114 uptake
115 volume
116 years
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