Impact on Prognosis Following Nonanatomical Resection of Hepatocellular Carcinoma Postoperatively Proven as Micro Portal Vein Tumor Thrombus on Histology

IF 0.2 4区 医学 Q4 SURGERY
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.
肝细胞癌术后证实为微门静脉肿瘤栓的非解剖切除对预后的影响
肝细胞癌(HCC)的肝内复发模式和/或手术程序(解剖切除[AR]和非解剖切除[NAR])对术后证实有门静脉癌栓的患者的预后影响尚未得到明确的检查。对52例HCC患者进行了分析,这些患者术前没有可见的肉眼可见的血管侵犯,术后经组织学证实在二级门静脉分支远端有门静脉瘤栓。采用Kaplan-Meier方法分析总生存率和无病生存率。采用对数秩检验分析肝内复发和远处转移的危险因素。根据手术程序,5年时的总生存率没有显著差异。3年无病生存率分别为59.2%(AR组)和30.1%(NAR组),具有统计学意义。在5例接受NAR的患者中,发现同一残留节段的肝内复发。这些病例同时发生了多个双叶复发,包括同一节段,并且在任何情况下都没有发现仅在同一残余节段复发,无论是单独复发还是多次复发。相同残段的肝内复发不会影响NAR后患者的无病生存率。尽管AR是一种理想的手术,但目前的研究表明,对于不能考虑进行AR的患者,NAR可以获得相同的结果。
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来源期刊
International surgery
International surgery 医学-外科
CiteScore
0.30
自引率
0.00%
发文量
10
审稿时长
6-12 weeks
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: -worldwide internet transmission -prompt peer reviews -timely publishing following peer review approved manuscripts -even more timely worldwide transmissions of unedited peer review approved manuscripts (“online first”) prior to having copy edited manuscripts formally published. Non-approved peer reviewed manuscript authors have the opportunity to update and improve manuscripts prior to again submitting for peer review.
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