Hepatic Resection for Hepatocellular Carcinoma With Lymph Node Metastasis: Clinicopathological Analysis and Survival Outcome

161 Background: Optimal treatment strategy for patients with liver metastasis from gastric cancer (LMGC) has not yet been established. Although systemic chemotherapy remains mainstay of treatment for LMGC, complete resection of primary tumor and LMGC may improve survival outcome. Thus, the aim of this study is to investigate survival outcome and prognostic factors of patients who underwent hepatic resection for LMGC. Methods: From September 2002 to February 2014, 30 patients underwent hepatic resection for LMGC in our hospital. Indications of hepatic resection were as follows; (1) hepatic lesion is not more than three, (2) without extrahepatic metastasis other than lymph node metastasis, (3) adequate liver function. We investigated the overall median survival time (MST) and 5-year survival rate of all eligible patients. Univariate and multivariate analyses were performed to assess the association between each clinicopathological features and overall survival time. Results: There were 25 males and 5 females with a median age of 72 (range, 39-86). There were 16 synchronous LMGCs and 14 metachronous LMGCs. With respect to the number of LMGC, 22 patients had 1 lesion, 7 patients had 2 lesions, and 1 patient had 3 lesions. Overall MST and 5 year survival rates after hepatic resection were 2.8 years and 31.0%, respectively. The significant prognostic factors were age (70 years or older, p=0.029) and blood transfusion (p=0.013). Multivariate analysis showed that lymph node metastasis was an only independent indicator of poor prognosis (HR=6.13, p=0.026). Conclusions: Hepatic resection for patients with LMGC might be a promising treatment strategy, with 5-year survival rate of 31.0%. Lymph node metastasis was an only independent prognostic factor. A multi-institutional confirmatory study will be required to evaluate the role of hepatic resection in patients with LMGC.

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SURGICAL RESECTION OF MEDIASTINAL LYMPH NODE METASTASIS OF HEPATOCELLULAR CARCINOMA AFTER HEPATIC RESECTION-A CASE REPORT-

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.70.491 ◽

2009 ◽

Vol 70 (2) ◽

pp. 491-495

Author(s):

Nobuyuki TAMAKI ◽

Kojiro TAURA ◽

Hirokazu KOTANI ◽

Shinji UEMOTO

Keyword(s):

Hepatocellular Carcinoma ◽

Case Report ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Hepatic Resection ◽

Surgical Resection ◽

Mediastinal Lymph Node ◽

Mediastinal Lymph Node Metastasis ◽

Node Metastasis

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Combination of three-dimensional reconstruction technique and blood parameters for the evaluation of tumor burden and prognosis in patients with hepatocellular carcinoma undergoing liver resection

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v23i2.35799 ◽

2020 ◽

Vol 23 (2) ◽

pp. 18-30

Author(s):

Bibesh Pokhrel ◽

Xiaopeng Hong ◽

Baojia Zou ◽

Baimeng Zhang ◽

Jian Li

Keyword(s):

Hepatocellular Carcinoma ◽

Lymph Node ◽

Liver Resection ◽

Lymph Node Metastasis ◽

Hepatic Resection ◽

Three Dimensional ◽

Blood Parameters ◽

Reconstruction Technique ◽

Three Dimensional Imaging ◽

Node Metastasis

Introduction: Hepatic resection is the mainstay of treatment for Hepatocellular carcinoma (HCC). Three- dimensional technique helps to create an image of the liver using pre-operative computed tomography (CT) scans which can be used for planning of surgery and counselling of the patient. Various lab parameters have also been shown to affect the prognosis of HCC. This study was designed to analyse whether three dimensional technique and blood parameters are correlated with the prognosis among HCC patients following hepatic resection and also to find a relation between these variables. Methods: Data were collected retrospectively to recruit HCC patients treated between January 2010 and December 2016. Seventy-three HCC patients without extrahepatic metastasis, who underwent hepatic resection and had pre-operative CT scan done in our centre were enrolled for this study. IQQA® was used to create a three-dimensional imaging, and various related laboratory parameters were also collected. Outcomes of these patients were calculated to establish a relationship between IQQA, laboratory results and the prognosis of the patients. Results: The one, three and five year overall survival (OS) rates were 94.4%, 53.3% and 19.4% respectively, and disease-free survival (DFS) rates were 75%, 31.3% and 12.8% respectively. IQQA percentage of tumor was statistically significant for both OS and DFS. In the multivariate analysis, patients having lymph node metastasis, vascular invasion and high pre-op CA 19-9 had lower DFS rate, while it increased in those with high pre-op albumin. Other significant variables for OS were lymph node metastasis, Child Pugh score, high pre-op alpha fetoprotein (AFP) value and high CA 19-9. Resected segments, lymph node metastasis, liver cirrhosis, blood loss and hospital stay were significant between the two IQQA subgroups (IQQA?30% and IQQA>30%). Additionally in these IQQA subgroups, significant difference was found between DFS and OS. Conclusion: IQQA software is helpful to create a 3D image of the liver, and can be combined with lab parameters to predict prognosis for patients with liver cancer. Therefore, this three-dimensional imaging technique can be used as a routine technique for patients undergoing liver resection.

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