DOI QR코드

DOI QR Code

Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection

  • Li, Shu-Hong (Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University) ;
  • Guo, Zhi-Xing (State Key Laboratory of Oncology in South China) ;
  • Xiao, Cheng-Zuo (Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University) ;
  • Wei, Wei (Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University) ;
  • Shi, Ming (Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University) ;
  • Chen, Zhi-Yuan (Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University) ;
  • Cai, Mu-Yan (State Key Laboratory of Oncology in South China) ;
  • Zheng, Lie (State Key Laboratory of Oncology in South China) ;
  • Guo, Rong-Ping (Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University)
  • 발행 : 2013.08.30

초록

Background: Prognostic factors of postoperative early and late recurrence in patients with hepatocellular carcinoma (HCC) undergoing curative resection remain to be clarified. The aim of this study was to identify risk factors for postoperative early (${\leq}$ 2 year) and late (> 2 year) intrahepatic recurrences in patients with single HCCs without macrovascular invasion. Methods: A total of 280 patients from December 2004 to December 2007 were retrospectively included in this study. Intrahepatic recurrence was classified into early (${\leq}$ 2 year) and late (> 2 year) and the Chi-Square test or Fisher's exact test and multivariate logistic regression analysis were performed to determine significant risk factors. Results: During the follow-up, 124 patients had intrahepatic recurrence, early and late in 82 and 42 patients, respectively. Multivariate logistic regression analysis showed that microvascular invasion (p=0.006, HR: 2.397, 95% CI: 1.290-4.451) was the only independent risk factor for early recurrence, while being female (p = 0.031, HR: 0.326, 95% CI: 0.118-0.901), and having a high degree of cirrhosis (P=0.001, HR: 2.483, 95% CI: 1.417-4.349) were independent risk factors for late recurrence. Conclusions: Early and late recurrence of HCC is linked to different risk factors in patients with single HCC without macrovascular invasion. This results suggested different emphases of strategies for prevent of recurrence after curative resection, more active intervention including adjuvant therapy, anti-cirrhosis drugs and careful follow-up being necessary for patients with relevant risk factors.

키워드

참고문헌

  1. Cabibbo G, Craxi A (2010). Epidemiology, risk factors and surveillance of hepatocellular carcinoma. Eur Rev Med Pharmacol Sci, 14, 352-5.
  2. Chen YJ, Yeh SH, Chen JT, et al (2000). Chromosomal changes and clonality relationship between primary and recurrent hepatocellular carcinoma. Gastroenterology, 119, 431-40. https://doi.org/10.1053/gast.2000.9373
  3. Chok KS, Chan SC, Cheung TT, et al (2011). Late recurrence of hepatocellular carcinoma after liver transplantation. World J Surg, 35, 2058-62. https://doi.org/10.1007/s00268-011-1146-z
  4. Chua TC, Saxena A, Chu F, et al (2011). Hepatic resection with or without adjuvant iodine-131-lipiodol for hepatocellular carcinoma: a comparative analysis. Int J Clin Oncol, 16, 125-32. https://doi.org/10.1007/s10147-010-0143-9
  5. Chun JM, Kwon HJ, Sohn J, et al (2011). Prognostic factors after early recurrence in patients who underwent curative resection for hepatocellular carcinoma. J Surg Oncol, 103, 148-51. https://doi.org/10.1002/jso.21786
  6. El-Serag HB, Mason AC (1999). Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med, 340, 745-50. https://doi.org/10.1056/NEJM199903113401001
  7. Fan ST, Lo CM, Liu CL, et al (1999). Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg, 229, 322-30. https://doi.org/10.1097/00000658-199903000-00004
  8. Fan ST, Yang ZF, Ho DW, et al (2011). Prediction of posthepatectomy recurrence of hepatocellular carcinoma by circulating cancer stem cells: a prospective study. Ann Surg, 254, 569-76. https://doi.org/10.1097/SLA.0b013e3182300a1d
  9. Ho CM, Lee PH, Chen CL, et al (2012). Long-term outcomes after resection versus transplantation for hepatocellular carcinoma within UCSF criteria. Ann Surg Oncol, 19, 826-33. https://doi.org/10.1245/s10434-011-1975-x
  10. Imamura H, Matsuyama Y, Tanaka E, et al (2003). Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol, 38, 200-7.
  11. John AR, Khan S, Mirza DF, et al (2006). Multivariate and univariate analysis of prognostic factors following resection in HCC: the Birmingham experience. Dig Surg, 23, 103-9. https://doi.org/10.1159/000093779
  12. Jung KS, Kim SU, Choi GH, et al (2012). Prediction of recurrence after curative resection of hepatocellular carcinoma using liver stiffness measurement (FibroScan(R)). Ann Surg Oncol, 19, 4278-86. https://doi.org/10.1245/s10434-012-2422-3
  13. Jwo SC, Chiu JH, Chau GY, et al (1992). Risk factors linked to tumor recurrence of human hepatocellular carcinoma after hepatic resection. Hepatology, 16, 1367-71. https://doi.org/10.1002/hep.1840160611
  14. Kamiyama T, Nakanishi K, Yokoo H, et al (2009). Recurrence patterns after hepatectomy of hepatocellular carcinoma: implication of Milan criteria utilization. Ann Surg Oncol, 16, 1560-71. https://doi.org/10.1245/s10434-009-0407-7
  15. Kang CM, Choi GH, Kim DH, et al (2010). Revisiting the role of nonanatomic resection of small (< or = 4 cm) and single hepatocellular carcinoma in patients with well-preserved liver function. J Surg Res, 160, 81-9. https://doi.org/10.1016/j.jss.2009.01.021
  16. Lau H, Fan ST, Ng IO, Wong J (1998). Long term prognosis after hepatectomy for hepatocellular carcinoma: a survival analysis of 204 consecutive patients. Cancer, 83, 2302-11. https://doi.org/10.1002/(SICI)1097-0142(19981201)83:11<2302::AID-CNCR9>3.0.CO;2-1
  17. Matsumata T, Kanematsu T, Takenaka K, et al (1989). Patterns of intrahepatic recurrence after curative resection of hepatocellular carcinoma. Hepatology, 9, 457-60. https://doi.org/10.1002/hep.1840090320
  18. Muscari F, Foppa B, Carrere N, et al (2011). Resection of a transplantable single-nodule hepatocellular carcinoma in Child-Pugh class A cirrhosis: factors affecting survival and recurrence. World J Surg, 35, 1055-62. https://doi.org/10.1007/s00268-011-1000-3
  19. Parkin DM, Bray F, Ferlay J, Pisani P (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  20. Poon RT, Fan ST, Lo CM, et al (1999). Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg, 229, 216-22. https://doi.org/10.1097/00000658-199902000-00009
  21. Poon RT, Fan ST, Lo CM, et al (2002). Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg, 235, 373-82. https://doi.org/10.1097/00000658-200203000-00009
  22. Poon RT, Fan ST, Ng IO, et al (2000). Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer, 89, 500-7. https://doi.org/10.1002/1097-0142(20000801)89:3<500::AID-CNCR4>3.0.CO;2-O
  23. Portolani N, Coniglio A, Ghidoni S, et al (2006). Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg, 243, 229-35. https://doi.org/10.1097/01.sla.0000197706.21803.a1
  24. Sumie S, Kuromatsu R, Okuda K, et al (2008). Microvascular invasion in patients with hepatocellular carcinoma and its predictable clinicopathological factors. Ann Surg Oncol, 15, 1375-82. https://doi.org/10.1245/s10434-008-9846-9
  25. Taketomi A, Toshima T, Kitagawa D, et al (2010). Predictors of extrahepatic recurrence after curative hepatectomy for hepatocellular carcinoma. Ann Surg Oncol, 17, 2740-6. https://doi.org/10.1245/s10434-010-1076-2
  26. Toyosaka A, Okamoto E, Mitsunobu M, et al (1996). Pathologic and radiographic studies of intrahepatic metastasis in hepatocellular carcinoma; the role of efferent vessels. HPB Surg, 10, 97-103; discussion 103-4. https://doi.org/10.1155/1996/75210
  27. Wu JC, Huang YH, Chau GY, et al (2009). Risk factors for early and late recurrence in hepatitis B-related hepatocellular carcinoma. J Hepatol, 51, 890-7. https://doi.org/10.1016/j.jhep.2009.07.009
  28. Yamamoto J, Kosuge T, Takayama T, et al (1996). Recurrence of hepatocellular carcinoma after surgery. Br J Surg, 83, 1219-22. https://doi.org/10.1002/bjs.1800830913
  29. Zhang XF, Meng B, Qi X, et al (2009). Prognostic factors after liver resection for hepatocellular carcinoma with hepatitis B virus-related cirrhosis: surgeon’s role in survival. Eur J Surg Oncol, 35, 622-8. https://doi.org/10.1016/j.ejso.2008.08.003
  30. Zhou YM, Yang JM, Li B, et al (2010). Risk factors for early recurrence of small hepatocellular carcinoma after curative resection. Hepatobiliary Pancreat Dis Int, 9, 33-7.

피인용 문헌

  1. Hepatitis B Virus DNA Negativity Acts as a Favorable Prognostic Factor in Hepatocellular Carcinoma Patients vol.15, pp.22, 2014, https://doi.org/10.7314/APJCP.2014.15.22.9635
  2. Influence of Clinically Significant Portal Hypertension on Hepatectomy for Hepatocellular Carcinoma: a Meta-analysis vol.15, pp.4, 2014, https://doi.org/10.7314/APJCP.2014.15.4.1649
  3. PKM2 Regulates Hepatocellular Carcinoma Cell Epithelial-mesenchymal Transition and Migration upon EGFR Activation vol.15, pp.5, 2014, https://doi.org/10.7314/APJCP.2014.15.5.1961
  4. Schedule-Dependent Effects of Kappa-Selenocarrageenan in Combination with Epirubicin on Hepatocellular Carcinoma vol.15, pp.8, 2014, https://doi.org/10.7314/APJCP.2014.15.8.3651
  5. Adjuvant and chemopreventive therapies for resectable hepatocellular carcinoma: a literature review vol.35, pp.10, 2014, https://doi.org/10.1007/s13277-014-2443-6
  6. 2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma vol.16, pp.3, 2015, https://doi.org/10.3348/kjr.2015.16.3.465
  7. The prognostic value of microvascular invasion in early-intermediate stage hepatocelluar carcinoma: a propensity score matching analysis vol.18, pp.1, 2018, https://doi.org/10.1186/s12885-018-4196-x
  8. Stereotactic body radiotherapy based treatment for hepatocellular carcinoma with extensive portal vein tumor thrombosis vol.13, pp.1, 2018, https://doi.org/10.1186/s13014-018-1136-5