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Prognostic factors after hepatic resection for the single hepatocellular carcinoma larger than 5 cm

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: This study aimed to determine which factors affect the prognosis of hepatectomy for hepatocellular carcinoma (HCC) larger than 5 cm, including the prognostic difference between tumor sizes from 5–10 cm and larger than 10 cm.

Methods: The medical records of 114 patients who underwent hepatectomy for single HCC larger than 5 cm were reviewed and analyzed retrospectively.

Results: In the analysis of the entire cohort of 114 patients, the 5-year overall and diseases-free survival rates were 50% and 29%, respectively. In a comparison of survival rates between groups, tumor sizes of 5 to 10 cm and larger than 10 cm, the overall and disease-free survival rates were not significantly different, respectively (54% vs. 41%, P = 0.433 and 33% vs. 23%, P = 0.083). On multivariate analysis, positive hepatitis B, high prothrombin induced by vitamin K absence or antagonist-II levels over 200 mIU/mL, and vascular invasion (micro- and macrovascular invasion) were independent prognostic factors for recurrence after hepatic resection. However, tumor size larger than 10 cm was not significant for recurrence after resection.

Conclusion: This study shows that surgical resection of solitary HCC larger than 5 cm showed favorable overall survival. And there is no survival difference with tumors between 5–10 cm and larger than 10 cm.

No MeSH data available.


Related in: MedlinePlus

Recurrence-free survival curves according to HBV (A), prothrombin induced by vitamin K absence or antagonist-II (B), the presence of portal vein gross invasion (C), and the presence of microvascular invasion (D).
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Figure 3: Recurrence-free survival curves according to HBV (A), prothrombin induced by vitamin K absence or antagonist-II (B), the presence of portal vein gross invasion (C), and the presence of microvascular invasion (D).

Mentions: The outcome of univariate and multivariate analysis of risk factors for tumor recurrence is summarized in Table 4. In univariate analysis, positive HBsAg, high level of α-FP (≥2,000 ng/mL), high level of PIVKA-II (≥200 mIU/mL), Edmonson-Steiner grade III/IV, the presence of portal vein gross invasion and microvascular invasion, and the presence of satellite nodule were significant factors to predict tumor recurrence after resection. However, tumor size over 10 cm, positive surgical margin, and anatomical resection were not associated with tumor recurrence. Multivariate analysis revealed that positive HBsAg (hazard ratio [HR], 1.94; P = 0.043), PIVKA ≥200 mIU/mL (HR, 3.07; P < 0.001), portal vein gross invasion (HR, 2.30; P = 0.011) and microvascular invasion (HR, 2.15; P = 0.004) were independent risk factors for HCC recurrence after resection in patients with single HCC larger than 5 cm. The differences of recurrent-free survival according to independent prognostic factors revealed in this study were shown in Fig. 3.


Prognostic factors after hepatic resection for the single hepatocellular carcinoma larger than 5 cm
Recurrence-free survival curves according to HBV (A), prothrombin induced by vitamin K absence or antagonist-II (B), the presence of portal vein gross invasion (C), and the presence of microvascular invasion (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016599&req=5

Figure 3: Recurrence-free survival curves according to HBV (A), prothrombin induced by vitamin K absence or antagonist-II (B), the presence of portal vein gross invasion (C), and the presence of microvascular invasion (D).
Mentions: The outcome of univariate and multivariate analysis of risk factors for tumor recurrence is summarized in Table 4. In univariate analysis, positive HBsAg, high level of α-FP (≥2,000 ng/mL), high level of PIVKA-II (≥200 mIU/mL), Edmonson-Steiner grade III/IV, the presence of portal vein gross invasion and microvascular invasion, and the presence of satellite nodule were significant factors to predict tumor recurrence after resection. However, tumor size over 10 cm, positive surgical margin, and anatomical resection were not associated with tumor recurrence. Multivariate analysis revealed that positive HBsAg (hazard ratio [HR], 1.94; P = 0.043), PIVKA ≥200 mIU/mL (HR, 3.07; P < 0.001), portal vein gross invasion (HR, 2.30; P = 0.011) and microvascular invasion (HR, 2.15; P = 0.004) were independent risk factors for HCC recurrence after resection in patients with single HCC larger than 5 cm. The differences of recurrent-free survival according to independent prognostic factors revealed in this study were shown in Fig. 3.

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: This study aimed to determine which factors affect the prognosis of hepatectomy for hepatocellular carcinoma (HCC) larger than 5 cm, including the prognostic difference between tumor sizes from 5&ndash;10 cm and larger than 10 cm.

Methods: The medical records of 114 patients who underwent hepatectomy for single HCC larger than 5 cm were reviewed and analyzed retrospectively.

Results: In the analysis of the entire cohort of 114 patients, the 5-year overall and diseases-free survival rates were 50% and 29%, respectively. In a comparison of survival rates between groups, tumor sizes of 5 to 10 cm and larger than 10 cm, the overall and disease-free survival rates were not significantly different, respectively (54% vs. 41%, P = 0.433 and 33% vs. 23%, P = 0.083). On multivariate analysis, positive hepatitis B, high prothrombin induced by vitamin K absence or antagonist-II levels over 200 mIU/mL, and vascular invasion (micro- and macrovascular invasion) were independent prognostic factors for recurrence after hepatic resection. However, tumor size larger than 10 cm was not significant for recurrence after resection.

Conclusion: This study shows that surgical resection of solitary HCC larger than 5 cm showed favorable overall survival. And there is no survival difference with tumors between 5&ndash;10 cm and larger than 10 cm.

No MeSH data available.


Related in: MedlinePlus