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Risk factors, prognosis, and management of early and late intrahepatic recurrence after resection of primary clear cell carcinoma of the liver.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2011 Jul; Vol. 18 (7), pp. 1955-63. Date of Electronic Publication: 2011 Jan 15. - Publication Year :
- 2011
-
Abstract
- Background: Primary clear cell carcinoma of the liver (PCCCL) is an uncommon variant of hepatocellular carcinoma (HCC). The prognostic factors influencing its recurrence and survival are not clarified. This study is to evaluate the predictive factors, the therapy, and prognosis of intrahepatic recurrences after resection of PCCCL.<br />Methods: A total of 214 PCCCL patients treated by curative resection from January 1996 to March 2006 were retrospectively analyzed. Intrahepatic recurrences were classified into early (≤1 year) and late (>1 year) recurrences.<br />Results: The 1-, 3-, and 5-year overall survival (OS) rates for PCCCL patients were significantly better than those of HCC patients (P = .001). Serum a-fetoprotein (AFP) level, tumor size, liver cirrhosis, and vascular invasion were independent risk factors for both OS and disease-free survival (DFS) of PCCCL. Early and late intrahepatic recurrences developed in 28 patients and 71 patients, respectively. In multivariate analysis, ALT level and vascular invasion were independent risk factors for early recurrence, whereas age was the only significant risk factor for late recurrence. OS of late-recurrence group was significantly better than that of early-recurrence group (P = .001), and re-resection rate was higher in late than in early-recurrence group (P = .04). The 1-, 3-, and 5-year OS of patients with recurrence who received curative treatment was comparable to those who never had tumor recur (P = .71).<br />Conclusion: PCCCL has a better prognosis and tends to recur later than HCC. Early and late recurrences of PCCCL are linked to different predictive factors. The time to recurrence and feasibility of curative treatment are the best determinants for the prognosis.
- Subjects :
- Adenocarcinoma, Clear Cell secondary
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular mortality
Carcinoma, Hepatocellular secondary
Carcinoma, Hepatocellular surgery
Female
Follow-Up Studies
Hepatectomy
Humans
Liver Neoplasms pathology
Male
Middle Aged
Neoplasm Recurrence, Local diagnosis
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Young Adult
Adenocarcinoma, Clear Cell mortality
Adenocarcinoma, Clear Cell surgery
Liver Neoplasms mortality
Liver Neoplasms surgery
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 18
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 21240562
- Full Text :
- https://doi.org/10.1245/s10434-010-1540-z