Impact on Prognosis Following Nonanatomical Resection of Hepatocellular Carcinoma Postoperatively Proven as Micro Portal Vein Tumor Thrombus on Histology
S. Komatsu, M. Kido, Motofumi Tanaka, H. Kinoshita, D. Tsugawa, M. Awazu, H. Gon, H. Toyama, K. Ueno, T. Ajiki, Y. Fujino, M. Tominaga, T. Fukumoto
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引用次数: 0
Abstract
The prognostic impact of intrahepatic recurrence pattern and/or operative procedure (anatomical resection [AR] and nonanatomical resection [NAR]) for hepatocellular carcinoma (HCC) in patients with postoperatively proven portal vein tumor thrombus on histology has not yet been clearly examined.
A total of 52 HCC patients who had no visible macroscopic vascular invasion preoperatively and histologically proven portal vein tumor thrombus distal to second-order portal branches after surgery were analyzed.
The overall survival and disease-free survival rates were analyzed using the Kaplan-Meier method. The risk factors for intrahepatic recurrence and distant metastasis were analyzed using the log-rank test.
There was no significant difference in the overall survival rates at 5 years, based on the operative procedure. The disease-free survival rates at 3 years were 59.2% (AR group) and 30.1% (NAR group), respectively, and were statistically significant. Intrahepatic recurrence in the same remnant segment was seen in 5 patients undergoing NAR. These cases developed multiple bilobar recurrences simultaneously, including the same segment, and recurrence only in the same remnant segment was not seen in any case, irrespective of solitary or multiple recurrence.
Intrahepatic recurrence in the same remnant segment does not influence the disease-free survival rate in patients after NAR. Although AR would be an ideal procedure, the current study suggests NAR can achieve identical outcomes for patients who cannot be considered for AR.
期刊介绍:
International Surgery is the Official Journal of the International College of Surgeons. International Surgery has been published since 1938 and has an important position in the global scientific and medical publishing field.
The Journal publishes only open access manuscripts. Advantages and benefits of open access publishing in International Surgery include:
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Non-approved peer reviewed manuscript authors have the opportunity to update and improve manuscripts prior to again submitting for peer review.