Cargando…
Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection
PURPOSE: The risk of hepatocellular carcinoma (HCC) recurrence must be considered ahead of surgery. This study was undertaken to identify pre-operative risk factors for early intrahepatic recurrence of HCC after curative resection in a large-scale. MATERIALS AND METHODS: We retrospectively reviewed...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
Yonsei University College of Medicine
2009
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796405/ https://www.ncbi.nlm.nih.gov/pubmed/20046419 http://dx.doi.org/10.3349/ymj.2009.50.6.789 |
_version_ | 1782175527543504896 |
---|---|
author | Kim, Honsoul Park, Mi-Suk Park, Young Nyun Kim, Hyunki Kim, Kyung Sik Choi, Jin Sub Ahn, Sang Hoon Han, Kwang-Hyub Kim, Myeong-Jin Kim, Ki Whang |
author_facet | Kim, Honsoul Park, Mi-Suk Park, Young Nyun Kim, Hyunki Kim, Kyung Sik Choi, Jin Sub Ahn, Sang Hoon Han, Kwang-Hyub Kim, Myeong-Jin Kim, Ki Whang |
author_sort | Kim, Honsoul |
collection | PubMed |
description | PURPOSE: The risk of hepatocellular carcinoma (HCC) recurrence must be considered ahead of surgery. This study was undertaken to identify pre-operative risk factors for early intrahepatic recurrence of HCC after curative resection in a large-scale. MATERIALS AND METHODS: We retrospectively reviewed the preoperative three-phase multi-detector CT (MDCT) and laboratory data for 240 HCC patients who underwent curative resection; tumor size, number, gross shape, capsule integrity, distinctiveness of tumor margin, portal vein thrombosis (PVT), alpha-fetoprotein level (AFP), and protein induced by vitamin K absence-II (PIVKA-II) levels were assessed. Surgical pathology was reviewed; tumor differentiation, capsule, necrosis, and micro-vessel invasion were recorded. RESULTS: HCC recurred in 61 patients within six months (early recurrence group), but not in 179 patients (control group). In univariate analysis, large tumor size (p = 0.018), shape (p = 0.028), poor capsule integrity (p = 0.046), elevated AFP (p = 0.015), and PIVKA-II (p = 0.008) were significant preoperative risk factors. Among the pathologic features, PVT (p = 0.023), Glisson's capsule penetration (p = 0.033), microvascular invasion (p < 0.001), and poor differentiation (p = 0.001) showed statistical significance. In multivariate analysis, only the histopathologic parameters of microvascular invasion and poor differentiation achieved statistical significance. CONCLUSION: Preoperative CT and laboratory parameters showed limited value, while the presence of microscopic vascular tumor invasion and poorly differentiated HCC correlated with higher risk of early recurrence after curative resection. |
format | Text |
id | pubmed-2796405 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | Yonsei University College of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-27964052009-12-31 Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection Kim, Honsoul Park, Mi-Suk Park, Young Nyun Kim, Hyunki Kim, Kyung Sik Choi, Jin Sub Ahn, Sang Hoon Han, Kwang-Hyub Kim, Myeong-Jin Kim, Ki Whang Yonsei Med J Original Article PURPOSE: The risk of hepatocellular carcinoma (HCC) recurrence must be considered ahead of surgery. This study was undertaken to identify pre-operative risk factors for early intrahepatic recurrence of HCC after curative resection in a large-scale. MATERIALS AND METHODS: We retrospectively reviewed the preoperative three-phase multi-detector CT (MDCT) and laboratory data for 240 HCC patients who underwent curative resection; tumor size, number, gross shape, capsule integrity, distinctiveness of tumor margin, portal vein thrombosis (PVT), alpha-fetoprotein level (AFP), and protein induced by vitamin K absence-II (PIVKA-II) levels were assessed. Surgical pathology was reviewed; tumor differentiation, capsule, necrosis, and micro-vessel invasion were recorded. RESULTS: HCC recurred in 61 patients within six months (early recurrence group), but not in 179 patients (control group). In univariate analysis, large tumor size (p = 0.018), shape (p = 0.028), poor capsule integrity (p = 0.046), elevated AFP (p = 0.015), and PIVKA-II (p = 0.008) were significant preoperative risk factors. Among the pathologic features, PVT (p = 0.023), Glisson's capsule penetration (p = 0.033), microvascular invasion (p < 0.001), and poor differentiation (p = 0.001) showed statistical significance. In multivariate analysis, only the histopathologic parameters of microvascular invasion and poor differentiation achieved statistical significance. CONCLUSION: Preoperative CT and laboratory parameters showed limited value, while the presence of microscopic vascular tumor invasion and poorly differentiated HCC correlated with higher risk of early recurrence after curative resection. Yonsei University College of Medicine 2009-12-31 2009-12-18 /pmc/articles/PMC2796405/ /pubmed/20046419 http://dx.doi.org/10.3349/ymj.2009.50.6.789 Text en © Copyright: Yonsei University College of Medicine 2009 http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Honsoul Park, Mi-Suk Park, Young Nyun Kim, Hyunki Kim, Kyung Sik Choi, Jin Sub Ahn, Sang Hoon Han, Kwang-Hyub Kim, Myeong-Jin Kim, Ki Whang Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection |
title | Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection |
title_full | Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection |
title_fullStr | Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection |
title_full_unstemmed | Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection |
title_short | Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection |
title_sort | preoperative radiologic and postoperative pathologic risk factors for early intra-hepatic recurrence in hepatocellular carcinoma patients who underwent curative resection |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796405/ https://www.ncbi.nlm.nih.gov/pubmed/20046419 http://dx.doi.org/10.3349/ymj.2009.50.6.789 |
work_keys_str_mv | AT kimhonsoul preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT parkmisuk preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT parkyoungnyun preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT kimhyunki preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT kimkyungsik preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT choijinsub preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT ahnsanghoon preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT hankwanghyub preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT kimmyeongjin preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection AT kimkiwhang preoperativeradiologicandpostoperativepathologicriskfactorsforearlyintrahepaticrecurrenceinhepatocellularcarcinomapatientswhounderwentcurativeresection |