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Microvascular invasion patterns affect survival in hepatocellular carcinoma patients after second hepatectomy.
- Source :
-
The Journal of surgical research [J Surg Res] 2016 Jan; Vol. 200 (1), pp. 82-90. Date of Electronic Publication: 2015 Jul 09. - Publication Year :
- 2016
-
Abstract
- Background: Microvascular invasion (MVI) is an important risk factor for survival of patients with hepatocellular carcinoma (HCC) after hepatectomy. However, its impact on patients with recurrent HCC who receive a second hepatectomy is unknown.<br />Methods: We enrolled 167 patients with HCC who underwent a second hepatectomy because of intrahepatic recurrences. We compared the patients' demographic, tumor, and pathologic characteristics with 766 cases of original hepatectomy. We analyzed the possible risk factors for survival after the first and second hepatectomies and the influence of different MVI patterns on patients' survival after the second hepatectomy.<br />Results: The median overall survival was comparable between the first and second hepatectomy groups, 34 (3-84) mo versus 27 (3-57) mo, P = 0.09. For patients who underwent a first hepatectomy, the presence of macro-VI or MVI, an early recurrence pattern, and a total tumor diameter >5 cm were independent risk factors. For survival after the second hepatectomy, MVI patterns that were positive-positive or negative-positive and a total recurrent tumor diameter >5 cm were significant risk factors for survival.<br />Conclusions: A second hepatectomy provides satisfying survival for patients with intrahepatic recurrence of HCC after the initial operation. Different MVI patterns affect survival after the second hepatectomy. Because MVI represents the biological behavior of HCC, we place a high premium on the clinical value of MVI after each hepatectomy.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular mortality
Carcinoma, Hepatocellular pathology
Female
Follow-Up Studies
Humans
Liver Neoplasms mortality
Liver Neoplasms pathology
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local pathology
Reoperation
Retrospective Studies
Risk Factors
Survival Analysis
Treatment Outcome
Young Adult
Carcinoma, Hepatocellular surgery
Hepatectomy
Liver Neoplasms surgery
Microvessels pathology
Neoplasm Recurrence, Local surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1095-8673
- Volume :
- 200
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of surgical research
- Publication Type :
- Academic Journal
- Accession number :
- 26259778
- Full Text :
- https://doi.org/10.1016/j.jss.2015.06.069