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Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study
BACKGROUND: Generally, a large tumor size of hepatocellular carcinoma (HCC) is associated with poor visibility and uncertainty in the surgical field which results in increased surgical difficulty as well as unfavorable postoperative outcomes. We performed intended preoperative trans-arterial emboliz...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939167/ https://www.ncbi.nlm.nih.gov/pubmed/35317819 http://dx.doi.org/10.1186/s12957-022-02563-9 |
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author | Saito, Ryo Amemiya, Hidetake Hosomura, Naohiro Kawaida, Hiromichi Shoda, Katsutoshi Furuya, Shinji Akaike, Hidenori Kawaguchi, Yoshihiko Inoue, Shingo Kono, Hiroshi Ichikawa, Daisuke |
author_facet | Saito, Ryo Amemiya, Hidetake Hosomura, Naohiro Kawaida, Hiromichi Shoda, Katsutoshi Furuya, Shinji Akaike, Hidenori Kawaguchi, Yoshihiko Inoue, Shingo Kono, Hiroshi Ichikawa, Daisuke |
author_sort | Saito, Ryo |
collection | PubMed |
description | BACKGROUND: Generally, a large tumor size of hepatocellular carcinoma (HCC) is associated with poor visibility and uncertainty in the surgical field which results in increased surgical difficulty as well as unfavorable postoperative outcomes. We performed intended preoperative trans-arterial embolization (TAE) in patients with a large HCC. In this study, we investigated the oncological significance of intended preoperative TAE for a large HCC, using a comparison between patients with and without TAE, and detailed analyses for pre- and post-TAE status. METHODS: A total of 411 patients who underwent hepatectomy for primary HCC at the University of Yamanashi Hospital between January 2007 and December 2018 were included in this study. The patients were divided into two groups: patients with larger HCCs (≥50 mm, n=51) and those with smaller HCC (<50 mm, n=360) according to the size of their HCCs. Comparison of clinicopathological features between these groups and clinical outcomes between the TAE and non-TAE groups were compared. In addition, a detailed analysis of each case in the TAE group was conducted, comparing clinicopathological factors between pre- and post-TAE status. RESULTS: The clinical unfavorable short- and long-term outcomes of patients with large HCCs (≥50 mm) were revealed compared to those with small HCCs (<50 mm). The prognostic analyses showed that a large tumor size and increased tumor markers, multiple tumor numbers, and others were adverse prognostic factors, and vascular invasions and residual tumors were included in the multivariate analysis. Further detailed analyses revealed that the average rates of change in tumor size and tumor shrinkage after TAE were − 48.6±35.6 mm and − 30.7±17.0%, respectively. Pathological high necrotic changes in the tumor, after multiple-times TAE aiming to a better effect, were related to a better prognosis in patients with large HCC. Poor prognostic factors became less common in patients who underwent intended preoperative TAE, and these patients had better prognoses. CONCLUSIONS: The large tumor size of HCC is associated with unfavorable outcomes; the intended preoperative TAE for large HCC patients performed multiple times aiming to affect the tumor as much as possible might improve their prognoses. |
format | Online Article Text |
id | pubmed-8939167 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89391672022-03-23 Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study Saito, Ryo Amemiya, Hidetake Hosomura, Naohiro Kawaida, Hiromichi Shoda, Katsutoshi Furuya, Shinji Akaike, Hidenori Kawaguchi, Yoshihiko Inoue, Shingo Kono, Hiroshi Ichikawa, Daisuke World J Surg Oncol Research BACKGROUND: Generally, a large tumor size of hepatocellular carcinoma (HCC) is associated with poor visibility and uncertainty in the surgical field which results in increased surgical difficulty as well as unfavorable postoperative outcomes. We performed intended preoperative trans-arterial embolization (TAE) in patients with a large HCC. In this study, we investigated the oncological significance of intended preoperative TAE for a large HCC, using a comparison between patients with and without TAE, and detailed analyses for pre- and post-TAE status. METHODS: A total of 411 patients who underwent hepatectomy for primary HCC at the University of Yamanashi Hospital between January 2007 and December 2018 were included in this study. The patients were divided into two groups: patients with larger HCCs (≥50 mm, n=51) and those with smaller HCC (<50 mm, n=360) according to the size of their HCCs. Comparison of clinicopathological features between these groups and clinical outcomes between the TAE and non-TAE groups were compared. In addition, a detailed analysis of each case in the TAE group was conducted, comparing clinicopathological factors between pre- and post-TAE status. RESULTS: The clinical unfavorable short- and long-term outcomes of patients with large HCCs (≥50 mm) were revealed compared to those with small HCCs (<50 mm). The prognostic analyses showed that a large tumor size and increased tumor markers, multiple tumor numbers, and others were adverse prognostic factors, and vascular invasions and residual tumors were included in the multivariate analysis. Further detailed analyses revealed that the average rates of change in tumor size and tumor shrinkage after TAE were − 48.6±35.6 mm and − 30.7±17.0%, respectively. Pathological high necrotic changes in the tumor, after multiple-times TAE aiming to a better effect, were related to a better prognosis in patients with large HCC. Poor prognostic factors became less common in patients who underwent intended preoperative TAE, and these patients had better prognoses. CONCLUSIONS: The large tumor size of HCC is associated with unfavorable outcomes; the intended preoperative TAE for large HCC patients performed multiple times aiming to affect the tumor as much as possible might improve their prognoses. BioMed Central 2022-03-22 /pmc/articles/PMC8939167/ /pubmed/35317819 http://dx.doi.org/10.1186/s12957-022-02563-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Saito, Ryo Amemiya, Hidetake Hosomura, Naohiro Kawaida, Hiromichi Shoda, Katsutoshi Furuya, Shinji Akaike, Hidenori Kawaguchi, Yoshihiko Inoue, Shingo Kono, Hiroshi Ichikawa, Daisuke Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study |
title | Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study |
title_full | Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study |
title_fullStr | Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study |
title_full_unstemmed | Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study |
title_short | Intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study |
title_sort | intended preoperative trans-arterial embolization for large hepatocellular carcinoma: a retrospective cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939167/ https://www.ncbi.nlm.nih.gov/pubmed/35317819 http://dx.doi.org/10.1186/s12957-022-02563-9 |
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