Incidence of Occult Intrahepatic Metastasis in Hepatocellular Carcinoma Treated With Transplantation Corresponds to Early Recurrence Rates After Partial Hepatectomy

Introduction: Hepatocellular carcinoma (HCC) is a common cancer and is the third most common cause of cancer-related death worldwide. Frequent recurrence of HCC after resection is a major surgical limitation. Early recurrence is the most disappointing outcome after surgery for multinodular HCC. Several studies found good results after hepatectomy for oligonodular (2 or 3 nodules) HCC. Objectives: To observe the recurrence rate three months after hepatectomy for oligonodular HCC and study the possible risk factors. Materials and Methods: The study population consisted of 102 patients with oligonodular HCC and received hepatectomy in Combined Military Hospital (CMH) between July 2011 and July 2017 according to the following criteria: (1) numbers of tumour nodules determined by preoperative imaging (computed tomography or magnetic resonance imaging) and intraoperative exploration; (2) diagnosis of HCC confirmed by postoperative histopathology; (3) incision margins negative; (4) complete clinicopathologic data; (5) adjuvant chemotherapy advised one month after operation. Multicentric occurrence (MO) and intrahepatic metastasis (IM) were determined in each patient according to the histopathologic examination. Results: Among 102 patients, 43(42.2%) had small tumor stain three months after surgery, 22(21.6%) and 21(20.6%) were definded as single and multiple recurrence respectively. The recurrence rate of patients with microvascular involvement was higher (64.3%) than those without (33.8%), (p<0.05). IM or MO, complete tumor capsule or not, number of tumors (2 versus 3), liver condition (cirrhosis versus chronic hepatitis) showed no significant difference. Conclusion: There was a high rate of very early recurrence for patients with oligonodular HCC three months ater hepatectomy, and the hepatic resection seems no-account for these patients regardless of very early recurrence or not a curative resection. Microvascular involvement was a risk factor while IM or MO is not. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 55-57

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Radiomics Analysis Based on Multiparametric MRI for Predicting Early Recurrence in Hepatocellular Carcinoma After Partial Hepatectomy

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.27424 ◽

2020 ◽

Author(s):

Ying Zhao ◽

Jingjun Wu ◽

Qinhe Zhang ◽

Zhengyu Hua ◽

Wenjing Qi ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Partial Hepatectomy ◽

Early Recurrence ◽

Multiparametric Mri

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MicroRNA-125b expression and intrahepatic metastasis are predictors for early recurrence after hepatocellular carcinoma resection

Hepatology Research ◽

10.1111/hepr.12990 ◽

2017 ◽

Vol 48 (4) ◽

pp. 313-321 ◽

Cited By ~ 11

Author(s):

Tomonari Shimagaki ◽

Tomoharu Yoshizumi ◽

Norifumi Harimoto ◽

Sachiyo Yoshio ◽

Yutaka Naito ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Early Recurrence ◽

Intrahepatic Metastasis

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Clinicopathological Risk Factors for Recurrence within One Year after Initial Hepatectomy for Hepatocellular Carcinoma

The American Surgeon ◽

10.1177/000313481107700516 ◽

2011 ◽

Vol 77 (5) ◽

pp. 572-578 ◽

Cited By ~ 11

Author(s):

Michihiro Hayashi ◽

Tetsunosuke Shimizu ◽

Fumitoshi Hirokawa ◽

Yoshihiro Inoue ◽

Koji Komeda ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

High Risk ◽

Early Recurrence ◽

Intrahepatic Metastasis ◽

High Rate ◽

Preoperative Imaging ◽

Curative Intent ◽

Initial Hepatectomy ◽

Cancer Spread

Hepatocellular carcinoma (HCC) shows a high rate of recurrence after hepatectomy; predictive factors for early recurrence would help determine optimal therapeutic and management strategies. Among 163 patients with HCC undergoing hepatectomy with curative intent, 46 patients developed recurrence within 1 year. Clinicopathological data were retrospectively analyzed to identify predictive parameters for early recurrence. Survival rates in cases of recurrence within 1 year were worse than those of no recurrence within 1 year or recurrence after 1 year. Protein induced by vitamin K absence/antagonist II (PIVKA-II) greater than 150, positive fucosylated alpha-fetoprotein (L3-AFP), and deviancy from Milan criteria (MC) on preoperative imaging were associated with high risk of early recurrence and total number of these three risk factors predicted the survival. With multivariate analysis, 1) preoperatively, positive factors of two or more among three items of PIVKA-II, L3-AFP, and deviancy from MC; 2) and postoperatively, pathological cancer spread (microscopic vascular invasion and/or intrahepatic metastasis) both represented risks for early recurrence. A combination of three preoperative factors, PIVKA-II, L3-AFP, and MC status, in conjunction with the postoperative factor of cancer spread status represents a significant indicator for recurrence within 1 year. Improving the prognosis of patients with HCC would depend on how to adequately treat those at high risk of early recurrence.

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High Expression of Macrophage Colony-Stimulating Factor in Peritumoral Liver Tissue Is Associated With Poor Survival After Curative Resection of Hepatocellular Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2007.15.6521 ◽

2008 ◽

Vol 26 (16) ◽

pp. 2707-2716 ◽

Cited By ~ 370

Author(s):

Xiao-Dong Zhu ◽

Ju-Bo Zhang ◽

Peng-Yuan Zhuang ◽

Hong-Guang Zhu ◽

Wei Zhang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Tissue ◽

Curative Resection ◽

Disease Free Survival ◽

Disease Recurrence ◽

Early Recurrence ◽

Intrahepatic Metastasis ◽

Poor Survival ◽

Large Tumor ◽

Macrophage Colony

Purpose To investigate prognostic values of the intratumoral and peritumoral expression of macrophage colony-stimulating factors (M-CSF) in hepatocellular carcinoma (HCC) patients after curative resection. Patients and Methods Expression of M-CSF and density of macrophages (MΦ) were assessed by immunohistochemistry in tissue microarrays containing paired tumor and peritumoral liver tissue from 105 patients who had undergone hepatectomy for histologically proven HCC. Prognostic value of these and other clinicopathologic factors was evaluated. Results Neither intratumoral M-CSF nor MΦ density was associated with overall survival (OS) or disease-free survival (DFS). High peritumoral M-CSF and MΦ density, which correlated with large tumor size, presence of intrahepatic metastasis, and high TNM stage, were independent prognostic factors for both OS (P = .001 and P < .001, respectively) and DFS (P = .001 and P = .003, respectively) and affected incidence of early recurrence. In a small HCC subset, peritumoral M-CSF was also correlated with both OS and DFS (P = .038 and P = .001, respectively). The combination of peritumoral M-CSF and MΦ had a better power to predict the patients' death and disease recurrence (P < .001 for both). Conclusion High peritumoral M-CSF and MΦ were associated with HCC progression, disease recurrence, and poor survival after hepatectomy, highlighting the importance of peritumoral tissue in the recurrence and metastasis of HCC. M-CSF and MΦ may be targets of postoperative adjuvant therapy.

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