Huge Hepatocellular Carcinoma Greater Than 10 cm in Diameter Worsens Prognosis by Causing Distant Recurrence After Curative Resection
Huge Hepatocellular Carcinoma Greater Than 10 cm in Diameter Worsens Prognosis by Causing Distant Recurrence After Curative Resection
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DOI：
10.1002/jso.24501
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发表时间：
2017-03-01
影响因子：
2.5
通讯作者：
Taketomi, Akinobu
中科院分区：
文献类型：
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作者：
Wakayama, Kenji;Kamiyama, Toshiya;Taketomi, Akinobu
背景和目标：这项研究旨在评估巨大的方法：对574例由17名外科医生行肝切除术的原发性肝癌（>= 10 cm）患者，采用放射免疫法检测其复发情况，并与术后复发情况及预后进行比较回顾性分析了1990年至2013年在单个研究所进行的无大血管侵犯的HCC（开放手术536例，腹腔镜手术38例）。巨大肿瘤、年龄、HCV、多发性肿瘤和显微镜下门静脉侵犯是总生存期（OS）的独立危险因素，而巨大肿瘤、ICGR 15 ≥ 16%、多发性肿瘤、中/差组织学、显微镜下门静脉侵犯和病理切缘阳性是无复发生存期（RFS）的危险因素。巨大HCC患者（n = 53）（42.9和14.2%）的5年OS和RFS显著差于HCC = 10 cm患者），由于初始肝外复发风险高，因此是一个独立的风险因素。这些患者需要进一步的全身辅助治疗。(C)2016 Wiley Periodicals，Inc.
Background and Objectives: This study aimed to evaluate the impact of huge (>= 10 cm) hepatocellular carcinoma (HCC) to the recurrence pattern and the prognosis after hepatectomy.Methods: 574 patients who underwent hepatectomy by 17 surgeons (Open 536 and Laparoscopic 38) for HCC without major vascular invasion from 1990 to 2013 at single institute were retrospectively analyzed.Results: Huge tumor, age, HCV, multiple tumors and microscopic portal invasion are independent risk factors for overall survival (OS), and huge tumor, ICGR15 >= 16%, multiple tumors, moderate/poor histology, microscopic portal invasion and a positive pathological margin are risk factors for relapse-free survival (RFS). The 5-year OS and RFS of patients with huge HCC (n = 53) (42.9 and 14.2%) were significantly worse than those of patients with HCC = 10 cm) is an independent risk factor due to a high risk for initial extra-hepatic recurrence. Future systemic adjuvant therapy is needed for these patients. (C) 2016 Wiley Periodicals, Inc.