Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma
Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma
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DOI：
10.1002/hep.510250116
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发表时间：
1997-01-01
期刊：
影响因子：
13.5
通讯作者：
Sassa, T
中科院分区：
文献类型：
--
作者：
Kumada, T;Nakano, S;Sassa, T
为探讨直径小于或等于2cm的小肝癌（HCC）初次治疗后肝内转移（IM）和多中心发生（MO）的情况，我们对1985年1月至1994年12月间112例接受经皮无水乙醇注射治疗（PEIT）或肝切除术的HCC患者进行了临床和病理研究。根据复发类型，将肝内复发患者分为两组：所述IM群（n = 29，50.9%）和MO组（n = 28，49.1%），IM患者初始治疗后1年、3年和5年的总复发率分别为23.7%、64.5%和76.1%，大多数肝内复发发生在初次治疗的3年内，原发性HCC病变与肿瘤细胞分化程度密切相关，或者，在MO患者的整个随访期间发生肝内复发，以及潜在肝病的证据（抗-HCV [HCV抗体]阳性）和血清甲胎蛋白（AFP）浓度升高与肝内复发密切相关，MO组患者追加治疗后的预后上级IM组，这些结果表明，HCC患者IM和MO之间的鉴别对于理解肿瘤的发展和生物学行为是重要的，即，肝内复发的早期发现和适当的额外治疗的制度（PEIT或肝切除）可能延长MO患者的生存期。
To assess intrahepatic metastasis (IM) and multicentric occurrence (MO) after initial treatment of small hepatocellular carcinomas (HCC) less than or equal to 2 cm in diameter, we performed clinical and pathological studies in 112 patients who underwent percutaneous ethanol injection therapy (PEIT) or hepatic resection for HCC from January 1985 to December 1994, Patients with intrahepatic recurrences were classified into two groups based on the type of recurrence: the IM group (n = 29, 50.9%) and the MO group (n = 28, 49.1%), Overall recurrence rates after initial treatment were 23.7% at 1 year, 64.5% at 3 years, and 76.1% at 5 years, in patients with IM, the majority of intrahepatic recurrences were observed within 3 years of initial treatment and the primary HCC lesions were closely related to the degree of tumor cell differentiation, Alternatively, intrahepatic recurrences occurred throughout the follow-up period in patients with MO, and the evidence of underlying liver disease (anti-HCV [antibody to hepatitis C virus] positive) and elevated serum alfa-fetoprotein (AFP) concentrations were closely associated with intrahepatic recurrence, Prognoses following additional treatment in MO group patients were superior to those in IM group patients, These results suggest that differentiation between IM and MO in patients with HCC is important for understanding the development and biological behavior of the tumor, That is, the early detection of intrahepatic recurrence and the institution of appropriate additional therapy (PEIT or hepatic resection) may prolong survival in patients with MO.