Microsatellite distribution and indication for locoregional therapy in small hepatocellular carcinoma
Microsatellite distribution and indication for locoregional therapy in small hepatocellular carcinoma
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DOI：
10.1002/cncr.20798
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发表时间：
2005-01-15
期刊：
影响因子：
6.2
通讯作者：
Kitano, S
中科院分区：
文献类型：
--
作者：
Sasaki, A;Kai, S;Kitano, S
背景肝细胞癌（HCC）患者在局部区域治疗后经常观察到肝内疾病复发。然而，局部治疗的适应症仍不清楚。为明确小肝癌局部区域治疗的适应证，作者测量了微卫星与主肿瘤的距离，并分析了该距离与临床病理因素的关系。作者回顾性分析了100例接受根治性肝切除术的小肝癌（直径小于或等于5 cm）患者。微卫星被定义为侵犯门静脉或肝内转移，并在光学显微镜下确定从主肿瘤到最远微卫星的距离。本研究调查了微卫星距离（0 mm，如果没有，小于或等于5 mm，5 mm）和临床病理因素之间的关系，以及肝切除术后的总体和无病生存率。在100例患者中，46例有微卫星，平均距离为9.9 mm（中位数，5.0 mm）。在研究的临床病理因素中，肿瘤分级和术前甲胎蛋白水平与微卫星的存在显著相关。肿瘤大小和微卫星的距离显著相关。除了1个与微卫星距离> 5 mil相关的肿瘤外，所有肿瘤都是最大尺寸> 25 mm的高级别肿瘤。微卫星间距> 5 mm患者的总生存率低于微卫星间距< 5 mm患者。局部区域治疗，包括有限切除和消融治疗，适用于低级别HCC肿瘤或肿瘤直径< 25 mm的患者。(C)2004年美国癌症协会。
BACKGROUND. Intrahepatic disease recurrence is observed frequently after locoregional therapies for patients with hepatocellular carcinoma (HCC). However, the indication for locoregional therapy is still unclear. To clarify the indication for locoregional therapy for small HCC tumors, the authors measured the distance of microsatellites from the main tumor and analyzed the relation between this distance and clinicopathologic factors.METHODS. The authors retrospectively analyzed 100 patients with small HCC tumors (less than or equal to 5 cm in dimension) treated by curative hepatectomy. A microsatellite was defined as invasion into the portal vein or intrahepatic metastasis, and the distance from the main tumor to the most distant microsatellite was determined under light microscopy. The current study investigated the relation between microsatellite distance (0 mm if none present, less than or equal to 5 mm, and 5 mm) and clinicopathologic factors, as well as overall and disease-free survival rates after hepatectomy.RESULTS. Of the 100 patients, 46 had microsatellites with a mean distance of 9.9 imn (median, 5.0 mm). Of the clinicopathologic factors investigated, tumor grade and preoperative alpha-fetoprotein level significantly correlated with the presence of a microsatellite. Tumor size and distance to the microsatellite were significantly correlated. All but 1 tumor associated with a microsatellite distance > 5 mill was a high-grade tumor > 25 mm in greatest dimension. The overall survival rate of patients with a microsatellite distance of > 5 mm was lower than that of patients with a microsatellite distance < 5 mm.CONCLUSIONS. Locoregional therapy, including limited resection and ablation therapies, was appropriate for patients with low-grade HCC tumors or with tumors < 25 mm in diameter. (C) 2004 American Cancer Society.